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General NPI Number Information
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NPI Number | 1346879202
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Entity Type | Organization
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Legal Business Name | RODE HEALTH SERVICES
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Dates
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Enumeration Date | 04/03/2020
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Last Update Date | 04/03/2020
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Provider Practice Location Address
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Address Line | 100 E PATAPSCO AVE
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City | BROOKLYN
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State | MD
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Zip | 21225-1733
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Country | US
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Telephone | 667-231-0317
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Fax |
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Provider Business Mailing Address
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Address Line | 9510 CAVEAT CT
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City | RANDALLSTOWN
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State | MD
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Zip | 21133-4662
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Country | US
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Telephone | 667-231-0317
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Fax |
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Authorized Official
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Title or Position | PSYCHIATRIC NURSE PRACTITIONER
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Name | AYODEJI OLAWALE
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Credential | CRNP-PMHNP-BC
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Telephone | 667-231-0317
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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