Provider Demographics
NPI:1730073198
Name:OLUKA, AJULU
Entity type:Individual
Prefix:MISS
First Name:AJULU
Middle Name:
Last Name:OLUKA
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 1:186 ELLA KINLEY CIR UNIT 102
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29588-4704
Mailing Address - Country:US
Mailing Address - Phone:813-763-5469
Mailing Address - Fax:813-441-8362
Practice Address - Street 1:730 MAIN ST # 230
Practice Address - Street 2:
Practice Address - City:NORTH MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29582-3030
Practice Address - Country:US
Practice Address - Phone:813-763-5469
Practice Address - Fax:813-441-8362
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician