Individual
MRS. OLAITAN ADESOLA EBODA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
811 CHURCH RD STE 219, CHERRY HILL, NJ 08002-1460
(732) 372-5963
Mailing address
811 CHURCH RD STE 219, CHERRY HILL, NJ 08002-1460
(732) 372-5963
Taxonomy
Speciality
Code
Description
License number
State
2084P0802X
Addiction Psychiatry Physician
26NJ01343700
NJ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26NJ01343700
NJ
Other
Enumeration date
07/22/2022
Last updated
03/28/2023
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