Individual
AYODEJI E OKORAFOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
58 MAIN ST STE 3, STURBRIDGE, MA 01566-1507
(781) 222-3979
Mailing address
15 STANLEY AVE, TAUNTON, MA 02780-3014
(617) 291-3744
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
RN2281539
MA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN2281539
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
S35673590
—
MA
Enumeration date
01/30/2018
Last updated
03/11/2024
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