Individual
BOLANLE OJO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDC-I
Contact information
Practice address
1401 DEZARAE APT 3, SAN ANTONIO, TX 78253-5986
(210) 530-4167
Mailing address
1818 ROGERS RD, SAN ANTONIO, TX 78251-4586
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
51484
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51484
LCDC-I
TX
Enumeration date
06/30/2022
Last updated
06/30/2022
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