Individual
FUNMILADE OLADIMEJI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
575 OAKSIDE PL, ACWORTH, GA 30102-8812
(770) 241-8091
Mailing address
575 OAKSIDE PL, ACWORTH, GA 30102-8812
(770) 241-8091
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
211765
GA
Other
Enumeration date
09/02/2019
Last updated
09/02/2019
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