Basic Information
Provider Information
NPI: 1679032239
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARAROMI
FirstName: YETUNDE
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: BOARD CERTIFIED BEHA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7108 S KANNER HIGHWAY S
Address2:  
City: STUART
State: FL
PostalCode: 349977462
CountryCode: US
TelephoneNumber: 8558326727
FaxNumber: 7726759100
Practice Location
Address1: 125 HALF MILE RD SUITE 200
Address2:  
City: RED BANK
State: NJ
PostalCode: 077016749
CountryCode: US
TelephoneNumber: 8558326727
FaxNumber: 7726759100
Other Information
ProviderEnumerationDate: 03/13/2019
LastUpdateDate: 06/15/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate: 05/12/2021
NPIReactivationDate: 06/10/2021
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/15/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103K00000X1-21-49293NJY Behavioral Health & Social Service ProvidersBehavioral Analyst 

No ID Information.


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