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General NPI Number Information
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NPI Number | 1568168540
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Entity Type | Individual
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Provider Name | MARIAM MOJISOLA AKINYEMI
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Gender | Female
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Dates
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Enumeration Date | 02/01/2023
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Last Update Date | 02/01/2023
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Provider Practice Location Address
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Address Line | 2288 BLUE WATER BLVD STE 317
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City | ODENTON
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State | MD
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Zip | 21113-3301
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Country | US
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Telephone | 443-302-2771
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Fax |
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Provider Business Mailing Address
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Address Line | 3205 W GLENREED CT
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City | GLENARDEN
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State | MD
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Zip | 20706-1579
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Country | US
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Telephone | 124-089-8516
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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 | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number | A00202202
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License Number State | MD
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