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Individual

BOLATITO OYERONKE OKOUGBO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
10926 W IVORY LN, AVONDALE, AZ 85392-4025
(623) 977-7644
Mailing address
10926 W IVORY LN, AVONDALE, AZ 85392-4025
(623) 877-7644

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
257217
AZ

Other

Enumeration date
05/03/2021
Last updated
05/03/2021
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