Individual
BOLAJI ADESIJI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1245 BIG POPLAR WAY, LOCUST GROVE, GA 30248-7241
(763) 269-9298
Mailing address
1245 BIG POPLAR WAY, LOCUST GROVE, GA 30248-7241
(763) 269-9298
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/19/2023
Last updated
07/19/2023
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