Individual
ALABA IFEOLUWA AWOSIKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2716 BEAR PAW DR, PORTAGE, IN 46368-2885
(219) 487-4393
Mailing address
2716 BEAR PAW DR, PORTAGE, IN 46368-2885
(219) 487-4393
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
32003203A
IN
Other
Enumeration date
05/15/2019
Last updated
05/15/2019
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