Individual
MODUPEOLUWA BABALOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1075 JESSE JEWELL PKWY SE SUITE B, GAINESVILLE, GA 30501-3827
(770) 219-5407
(770) 219-7102
Mailing address
601 E 66TH ST, SAVANNAH, GA 31405-4519
(912) 662-0088
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
10818
GA
390200000X
Student in an Organized Health Care Education/Training Program
10818
GA
Other
Enumeration date
04/15/2019
Last updated
01/30/2025
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