Individual
DR. IMUENTIYAN IGBINOSUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
1421 SE 4TH AVE FL 2, FORT LAUDERDALE, FL 33316-1900
(954) 766-4955
Mailing address
1421 SE 4TH AVE FL 2, FORT LAUDERDALE, FL 33316-1900
(954) 766-4955
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
07/29/2022
Last updated
01/19/2023
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