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General NPI Number Information
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NPI Number | 1093664138
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Entity Type | Individual
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Provider Name | KUDIRAT FUNKE ASEMOTA
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Gender | Female
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Dates
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Enumeration Date | 01/22/2026
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Last Update Date | 01/22/2026
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Provider Practice Location Address
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Address Line | 5174 BROOK WAY APT 3
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City | COLUMBIA
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State | MD
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Zip | 21044-1611
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Country | US
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Telephone | 855-832-6727
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Fax |
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Provider Business Mailing Address
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Address Line | 6509 QUIET HOURS APT T1
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City | COLUMBIA
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State | MD
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Zip | 21045-4936
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Country | US
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Telephone | 855-832-6727
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | BACB1456332
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License Number State | MD
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