Most Relevant Information
Provider Data
| NPI Number: | 1003407206 |
| Provider Name: | OBAOGODARA OLUWASANMI |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | 011010 |
Most Important Dates
| Enumeration Date: | 01/30/2021 |
| Last Updated: | 01/30/2021 |
Provider Practice Location
1600 FULTON ST APT 10F
BROOKLYN
NY
112131361
Practice Location Phone/Fax
| Phone: | 3475021284 |
| Fax: |
Provider Mailing Location
1600 FULTON ST APT 10F
BROOKLYN
NY
112131361
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |