Individual
MULIKAT MOYOSORE OTEPOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
22 COURT ST, FREEHOLD, NJ 07728-1700
(732) 780-7387
Mailing address
1 CHELSEA AVE APT 1-208, LONG BRANCH, NJ 07740-8109
(404) 441-8142
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26NJ00828400
NJ
Other
Enumeration date
06/15/2018
Last updated
06/15/2018
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