MR. TAIWO OLUSEGUN FOWOWE (NPI# 1134554603) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134554603 |
| Entity Type | Individual |
| Full Name | MR. TAIWO OLUSEGUN FOWOWE |
| Practice Address |
2005 Club Bay Dr Villa Rica GA 30180-5136 |
| Practice Telephone | 2675755092 |
| Mailing Telephone | 2675755092 |
| Enumeration Date | 2013-09-03 |
| Last Update Date | 2013-09-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 222Q00000X | Developmental Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
2005 CLUB BAY DR |
| City | VILLA RICA |
| State | GA |
| Zip Code | 30180-5136 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316306707 | Oluseyi Fowowe | Counselor | 2005 Club Bay Dr, Villa Rica, GA 30180 | 2016-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174161624 | Crucible Communication Therapy LLC | Speech-Language Pathologist | 9765 Walnut Grove Trail, Villa Rica, GA 30180 | 2019-12-16 |
| 1366802845 | Medic-pearl, LLC | Ambulance | 1108 Charter Oak Ct, Villa Rica, GA 30180 | 2016-02-26 |
| 1396138368 | Josette Etienne | Nurse Practitioner | 403 Permian Way Suite A, Villa Rica, GA 30180 | 2015-03-13 |
| 1447690516 | Judith L.m. Thigpen | Nurse Practitioner | 736 Highway 78 West, Minute Clinic, Villa Rica, GA 30180 | 2013-07-03 |
| 1477890168 | Wesley Douglas Mckenzie | Pharmacist | 2500 Mirror Lake Blvd, Villa Rica, GA 30180 | 2013-01-15 |
| 1497005359 | Malika Remie Rajendra | Optometrist | 600 Hwy 61, Villa Rica, GA 30180 | 2012-09-18 |
| 1972876449 | Catherine Elaine Tyson | Pharmacist | 601 Dallas Road, Villa Rica, GA 30180 | 2012-02-14 |
| 1619262433 | Villa Rica Rx LLC | Pharmacy | 222 West Wilson Street, Villa Rica, GA 30180 | 2011-06-09 |
| 1851602874 | Jules Chopin Sybert | Nurse Practitioner | 736 W. Bankhead Hwy, Villa Rica, GA 30180 | 2010-06-24 |
| 1487984019 | Lisa Wood | Occupational Therapy Assistant | 1207 Woods Walk, Villa Rica, GA 30180 | 2010-01-04 |
| Find all providers in zip 30180 | ||||
| Taxonomy Code | 222Q00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Developmental Therapist |
| A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Developmental Therapy Association. A developmental therapist evaluates children's global development in order to identify areas of developmental delay whether arising from physiological, neurological, or environmental factors, or a combination of factors; and designs, implements, and modifies therapeutic interventions for the child and the family to promote the child's acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction in order to maximize functional independence and developmental homeostasis, and improve the quality of life at home and in the community; and provides consultation for the parents and other professionals working with the family on global development. |
| Notes: Source: The Illinois Developmental Therapists Association [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003319740 | Lionel J Smith | Developmental Therapist | 5292 Deep Springs Dr, Stone Mountain, GA 30087-3623 | 2018-03-08 |
| 1295288009 | Bridget Howard | Developmental Therapist | 8 Forestay Ct, Savannah, GA 31410-2080 | 2016-07-27 |
| 1285002857 | Alexis Danielle Fortson | Developmental Therapist | 300 Colonial Center Pkwy Ste Nroswell, Roswell, GA 30076-4899 | 2015-09-12 |
| 1598132417 | Ashley Smith | Developmental Therapist | 300 Colonial Center Pkwy Ste 100n, Roswell, GA 30076-4892 | 2015-08-26 |
| 1386029718 | Theresa Scholfield | Developmental Therapist | 4012 Carlinswood Way, Stone Mountain, GA 30083-4775 | 2015-07-28 |
| 1689090508 | Catherine Strong | Developmental Therapist | 29 Ashlynn Ln, Midway, GA 31320-3903 | 2014-03-17 |
| 1487075040 | Wynter Bryant | Developmental Therapist | 3607 Uppark Dr, Atlanta, GA 30349-8733 | 2013-12-30 |
| 1629409719 | Shaddai Wiggs | Developmental Therapist | 372 Racetrack Rd, Mcdonough, GA 30252-1022 | 2013-11-27 |
| 1215379573 | Melonie Sherice Tucker | Developmental Therapist | 1481 Flo Zechman Dr, Hinesville, GA 31313-9103 | 2013-07-26 |
| 1851634372 | Azriana Johnson | Developmental Therapist | 2795 Evans Mill Rd Apt 3108, Lithonia, GA 30058-7723 | 2013-04-03 |
| Find all providers with the same taxonomy | ||||
| City | VILLA RICA |
| Zip Code | 30180 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.