Individual
ADEYINKA BOSEDE AGAGU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
0119004839
VA
225X00000X
Occupational Therapist
Primary
05062
MD
225X00000X
Occupational Therapist
0T100000186
DC
Other
Enumeration date
08/07/2011
Last updated
08/07/2011
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