Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor |
NPI | 1003258971 |
---|---|
Provider Name | Adedayo Adeala |
First Address | Laurel, MD 20708-2358 |
Second Address | Towson, MD 21286-3300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2013 |
Last Update Date | 01/08/2013 |