Provider Demographics
NPI:1396078259
Name:OPALEYE-OLUWO, ABIMBOLA (MS)
Entity type:Individual
Prefix:
First Name:ABIMBOLA
Middle Name:
Last Name:OPALEYE-OLUWO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1494 GRAVEL PIKE
Mailing Address - Street 2:
Mailing Address - City:GREEN LANE
Mailing Address - State:PA
Mailing Address - Zip Code:18054-2015
Mailing Address - Country:US
Mailing Address - Phone:215-234-9372
Mailing Address - Fax:215-234-9375
Practice Address - Street 1:1494 GRAVEL PIKE
Practice Address - Street 2:
Practice Address - City:GREEN LANE
Practice Address - State:PA
Practice Address - Zip Code:18054-2015
Practice Address - Country:US
Practice Address - Phone:215-234-9372
Practice Address - Fax:215-234-9375
Is Sole Proprietor?:No
Enumeration Date:2009-09-10
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health