Provider Demographics
NPI:1821972381
Name:AKINMARIN, OLUBUKOLAMI MODUPE
Entity type:Individual
Prefix:
First Name:OLUBUKOLAMI
Middle Name:MODUPE
Last Name:AKINMARIN
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 1:3082 ROBIE LN
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-3647
Mailing Address - Country:US
Mailing Address - Phone:678-663-9778
Mailing Address - Fax:
Practice Address - Street 1:3082 ROBIE LN
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-3647
Practice Address - Country:US
Practice Address - Phone:678-663-9778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-25-407979106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician