Provider Demographics
NPI:1144044108
Name:OLAMIJU, OLAOLUWA JOSHUA
Entity type:Individual
Prefix:
First Name:OLAOLUWA
Middle Name:JOSHUA
Last Name:OLAMIJU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9243 ALCONA ST
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2447
Mailing Address - Country:US
Mailing Address - Phone:301-844-8511
Mailing Address - Fax:
Practice Address - Street 1:1919 N BROADWAY
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21213-1432
Practice Address - Country:US
Practice Address - Phone:301-844-8511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool