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General NPI Number Information
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NPI Number | 1679792790
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Entity Type | Individual
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Provider Name | SARIAT ADEBOWALE ADENIJI-ADELE O.T.
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Gender | Female
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4140 OLD WASHINGTON RD
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City | WALDORF
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State | MD
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Zip | 20602-3221
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Country | US
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Telephone | 301-645-2813
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Fax |
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Provider Business Mailing Address
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Address Line | 4406 WINDFLOWER WAY
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City | BOWIE
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State | MD
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Zip | 20720-6200
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Country | US
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Telephone | 301-918-0014
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Fax | 301-918-0015
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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 | 04073
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License Number State | MD
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