Provider Demographics
NPI:1588933428
Name:ADELEYE, ADEKUNLE O (REHAB SPECIALIST)
Entity type:Individual
Prefix:MR
First Name:ADEKUNLE
Middle Name:O
Last Name:ADELEYE
Suffix:
Gender:M
Credentials:REHAB SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10308 S KLEIN AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-2970
Mailing Address - Country:US
Mailing Address - Phone:405-412-2977
Mailing Address - Fax:
Practice Address - Street 1:10308 S KLEIN AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-2970
Practice Address - Country:US
Practice Address - Phone:405-412-2977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK22756103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation