Healthcare Provider Details

I. General information

NPI: 1609770981
Provider Name (Legal Business Name): OLUWAYEMISI C BABALADE LGP18326
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3933 WARNER AVE APT C1
HYATTSVILLE MD
20784-2066
US

IV. Provider business mailing address

3933 WARNER AVE APT C1
HYATTSVILLE MD
20784-2066
US

V. Phone/Fax

Practice location:
  • Phone: 202-604-3736
  • Fax:
Mailing address:
  • Phone: 202-604-3736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberLGP18326
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: