Provider Demographics
NPI:1366284424
Name:RODRIQUES-AKINSOLA, ADEOLA
Entity type:Individual
Prefix:
First Name:ADEOLA
Middle Name:
Last Name:RODRIQUES-AKINSOLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4270 SECRET SHOALS WAY
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30518-8850
Mailing Address - Country:US
Mailing Address - Phone:404-210-1009
Mailing Address - Fax:
Practice Address - Street 1:4270 SECRET SHOALS WAY
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518-8850
Practice Address - Country:US
Practice Address - Phone:404-210-1009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty