Healthcare Provider Details

I. General information

NPI: 1710832415
Provider Name (Legal Business Name): OLUBUKOLA BOLANLE BAKARE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9508 ANNAPOLIS RD
LANHAM MD
20706
US

IV. Provider business mailing address

5901 MONTROSE RD APT S1401
NORTH BETHESDA MD
20852-4742
US

V. Phone/Fax

Practice location:
  • Phone: 301-850-1148
  • Fax:
Mailing address:
  • Phone: 667-421-9117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: