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Individual

OLAYINKA SAMUEL FAWEHINMI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSCM

Contact information

Practice address
188 ACADEMY AVE, PROVIDENCE, RI 02908-4452
(405) 509-1011
Mailing address
188 ACADEMY AVE, PROVIDENCE, RI 02908-4452
(405) 509-1011

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
06/11/2024
Last updated
06/11/2024
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