Individual provider · Type 1 NPI

Modebola Fadare

Mental Health Counselor · Oklahoma City, OK

NPI number 1063754182 Active

Practice location

9210 S Western Ave, Ste A-21
Oklahoma City, OK 73139-4982

Call (405) 246-9259 Map

Fax (405) 606-7893

Specialties and licenses

TaxonomyCodeLicense
Rehabilitation Practitioner 225400000XNone listed
Mental Health Counselor Primary 101YM0800XNone listed
Professional Counselor 101YP2500X6107 (OK)

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About NPI 1063754182

Modebola Fadare's National Provider Identifier is 1063754182, issued on Mar 27, 2013. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Oklahoma City, OK. The record was last updated on May 16, 2016.