Provider Demographics
NPI:1407646730
Name:DARAMOLA, DAMILOLA ESTHER (MA)
Entity type:Individual
Prefix:
First Name:DAMILOLA
Middle Name:ESTHER
Last Name:DARAMOLA
Suffix:
Gender:
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 N 200 W
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84341-2032
Mailing Address - Country:US
Mailing Address - Phone:435-512-8444
Mailing Address - Fax:
Practice Address - Street 1:1525 N 200 W
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84341-2032
Practice Address - Country:US
Practice Address - Phone:435-512-8444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program