Healthcare Provider Details

I. General information

NPI: 1831972637
Provider Name (Legal Business Name): OLUWATOYIN VICTORIA OGUNSANMI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2023
Last Update Date: 08/15/2023
Certification Date: 08/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9809 WOOD EDGE WAY
LANHAM MD
20706-3299
US

IV. Provider business mailing address

9809 WOOD EDGE WAY
LANHAM MD
20706-3299
US

V. Phone/Fax

Practice location:
  • Phone: 240-476-7202
  • Fax:
Mailing address:
  • Phone: 240-476-7202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: