Provider Demographics
NPI:1962283747
Name:ADEBARI, ALICE ADEBOLANLE
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:ADEBOLANLE
Last Name:ADEBARI
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 1:211 E SIX FORKS RD APT B
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7745
Mailing Address - Country:US
Mailing Address - Phone:984-212-5901
Mailing Address - Fax:
Practice Address - Street 1:211 E SIX FORKS RD APT B
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7745
Practice Address - Country:US
Practice Address - Phone:984-212-5901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical