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General NPI Number Information
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NPI Number | 1629480710
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Entity Type | Individual
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Provider Name | OMOLOLU MAJEKODUNMI OTR/L
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Gender | Male
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Dates
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Enumeration Date | 05/23/2014
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Last Update Date | 12/15/2023
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Provider Practice Location Address
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Address Line | 4900 MASSACHUSETTS AVE NW STE 340
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City | WASHINGTON
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State | DC
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Zip | 20016-4358
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Country | US
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Telephone | 202-794-6820
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Fax |
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Provider Business Mailing Address
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Address Line | 1710 W VIRGINIA AVE NE UNIT 101
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City | WASHINGTON
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State | DC
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Zip | 20002-2338
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Country | US
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Telephone | 202-739-1861
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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 | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 07155
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 224Y00000X
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Taxonomy Name | Clinical Exercise Physiologist
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 010000891
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License Number State | DC
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