Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | SC1414 | MD |
NPI | 1003271172 |
---|---|
Provider Name | Jinaki Olatunji |
First Address | Baltimore, MD 21215-6859 |
Second Address | Baltimore, MD 21218-5724 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2015 |
Last Update Date | 16/12/2015 |