Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Modebola Fadare

Individual provider Rehabilitation Practitioner · NPI 1063754182

Mr. Modebola Fadare is a Rehabilitation Practitioner in Oklahoma City, Oklahoma. Practices as a sole proprietor. Licensed in Oklahoma.

Licensed in
OK
In the registry since
2013
Specialties on file
3

Practice location Address checks out

9210 S Western Ave Ste A-21
Oklahoma City, OK 73139-4982
Phone: (405) 246-9259
Fax: (405) 606-7893
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X (OK)
Rehabilitation Practitioner Taxonomy 225400000X
Professional Counselor Taxonomy 101YP2500X · Licence 6107 (OK)

Record details

NPI number1063754182
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMarch 27, 2013
Last updated in NPPESMay 16, 2016

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