Healthcare Provider Details

I. General information

NPI: 1265271787
Provider Name (Legal Business Name): OLUWATOYIN AJAYI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2024
Last Update Date: 05/30/2024
Certification Date: 05/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6707 WHITESTONE RD
BALTIMORE MD
21207-4106
US

IV. Provider business mailing address

11015 MILL CENTRE DR
OWINGS MILLS MD
21117-3275
US

V. Phone/Fax

Practice location:
  • Phone: 667-755-2170
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: