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General NPI Number Information
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NPI Number | 1174991368
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Entity Type | Individual
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Provider Name | ELIZABETH AYOTUNDE ADEYEFA-OLASUPO OTR/L
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Gender | Female
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Dates
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Enumeration Date | 09/04/2015
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Last Update Date | 04/29/2024
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Provider Practice Location Address
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Address Line | 2644 RIVA RD
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City | ANNAPOLIS
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State | MD
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Zip | 21401-7427
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Country | US
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Telephone | 410-222-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 1800 TRIPLE FEATHER RD
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City | SEVERN
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State | MD
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Zip | 21144-1019
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Country | US
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Telephone | 240-605-7172
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT010001124
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 07700
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License Number State | MD
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