Individual
OLAWALE AGBOOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
616 MISTFLOWER DR NW, ACWORTH, GA 30102-6934
(317) 319-7616
Mailing address
616 MISTFLOWER DR NW, ACWORTH, GA 30102-6934
(317) 319-7616
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-665558
GA
103K00000X
Behavior Analyst
1-23-66558
GA
Other
Enumeration date
08/12/2019
Last updated
01/08/2024
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