Provider Demographics
NPI:1609660364
Name:AKINJOLIRE, MODUPEOLA CHRISTIANAH (MSN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:MODUPEOLA
Middle Name:CHRISTIANAH
Last Name:AKINJOLIRE
Suffix:
Gender:
Credentials:MSN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8754 LAURELTON PL
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-5809
Mailing Address - Country:US
Mailing Address - Phone:301-765-4539
Mailing Address - Fax:
Practice Address - Street 1:8754 LAURELTON PL
Practice Address - Street 2:
Practice Address - City:BROWNSBURG
Practice Address - State:IN
Practice Address - Zip Code:46112-5809
Practice Address - Country:US
Practice Address - Phone:301-765-4539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20250201802084A0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine