Individual
MISS OMOLOLA VICTORIA IMANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LCPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC12182
MD
101YP2500X
Professional Counselor
LGP9449
MD
101YP2500X
Professional Counselor
LGPC00489
DC
Other
Enumeration date
11/04/2019
Last updated
03/07/2022
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