Individual
OLUSEYI FOWOWE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2005 CLUB BAY DR, VILLA RICA, GA 30180
(267) 575-5087
Mailing address
2005 CLUB BAY DR, VILLA RICA, GA 30180-5136
(267) 575-5087
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/15/2016
Last updated
02/15/2016
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