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NPI Code Detail

MEDICARE: DADA OKUSANYA

MEDICARE: DADA OKUSANYA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorCACII1052DC

General Provider Information

NPI Number : 1861858334
Entity Type Code : Individual
Provider Name (Legal Business Name) : DADA OKUSANYA
Provider Business Mailing Address
First Line : 3005 BLADENSBURG RD NE
Second Line :
City : WASHINGTON
State : DC
Zip : 20018-2265
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3005 BLADENSBURG RD NE
Second Line :
City : WASHINGTON
State : DC
Zip : 20018-2265
Country : US
Telephone Number : 202-635-2320
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2016
Last Update Date : 01/13/2016

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Directions to “ DADA OKUSANYA ” Practice Location

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