Healthcare Provider Details

I. General information

NPI: 1285469452
Provider Name (Legal Business Name): BUKOLA TEMITOPE ALMAROOF
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2024
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 DAJOBE CT
RANDALLSTOWN MD
21133-2849
US

IV. Provider business mailing address

2 DAJOBE CT
RANDALLSTOWN MD
21133-2849
US

V. Phone/Fax

Practice location:
  • Phone: 443-500-9305
  • Fax:
Mailing address:
  • Phone: 443-500-9305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLGP17973
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLGA3618
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: