Healthcare Provider Details

I. General information

NPI: 1912329483
Provider Name (Legal Business Name): MULIKAT OLORUNSOLA HHA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2014
Last Update Date: 01/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3203 75TH AVE APT 203
HYATTSVILLE MD
20785-1940
US

IV. Provider business mailing address

3203 75TH AVE APT 203
HYATTSVILLE MD
20785-1940
US

V. Phone/Fax

Practice location:
  • Phone: 202-545-0935
  • Fax: 202-545-0934
Mailing address:
  • Phone: 202-545-0935
  • Fax: 202-545-0934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: