Fadare, Modebola

Fadare, Modebola is an sole proprietor health care provider with primary practice located at 9210 S Western Ave Ste A-21, Oklahoma City OK 73139-4982. He recently has 3 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Practitioner, Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Fadare, Modebola can be contacted via phone (405) 246-9259.

Contact Information

Primary practice address
9210 S Western Ave Ste A-21 Oklahoma City OK 73139-4982
Phone: (405) 246-9259
Fax: (405) 606-7893
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Practitioner 225400000X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X Oklahoma
Behavioral Health & Social Service Providers / Professional 101YP2500X 6107 Oklahoma

Profile Details

NPI number 1063754182
LBN Legal business name Fadare, Modebola
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 27th, 2013
Last updated May 16th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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