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Individual

DR. ADEMOLA FAWOLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
513 W CHOCOLATE AVE STE 100, HERSHEY, PA 17033
(717) 810-1974
(717) 704-8476
Mailing address
2726 MAXWELL ST, PHILADELPHIA, PA 19136-1017
(215) 939-0572

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
3565-57
WI
103T00000X
Psychologist
Primary
PS018734
PA

Other

Enumeration date
04/19/2018
Last updated
08/14/2019
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