Individual
IRENE OLUFUNKE DISU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
405 PHILIP BLVD APT 212, LAWRENCEVILLE, GA 30046-8751
(770) 728-3238
Mailing address
405 PHILIP BLVD APT 212, LAWRENCEVILLE, GA 30046-8751
(770) 728-3238
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/03/2025
Last updated
02/03/2025
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