Individual
KOKU LOLOWU AFETO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
15032 107TH AVE, JAMAICA, NY 11433-1902
(347) 659-2357
Mailing address
15032 107TH AVE, JAMAICA, NY 11433-1902
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
11/01/2023
Last updated
11/01/2023
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