Provider Demographics
NPI:1912744392
Name:OLADIGBO, SODIQ
Entity type:Individual
Prefix:MR
First Name:SODIQ
Middle Name:
Last Name:OLADIGBO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 HAMILTON MILL RD
Mailing Address - Street 2:SUITE 102 #243
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519
Mailing Address - Country:US
Mailing Address - Phone:470-342-2999
Mailing Address - Fax:
Practice Address - Street 1:1400 BUFORD HWY STE R1
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518-8777
Practice Address - Country:US
Practice Address - Phone:470-342-2999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health