Provider Demographics
NPI:1144933540
Name:ENIOBAMO ADEJORIN, OLUWANBE IDOWU (CSS)
Entity type:Individual
Prefix:
First Name:OLUWANBE
Middle Name:IDOWU
Last Name:ENIOBAMO ADEJORIN
Suffix:
Gender:F
Credentials:CSS
Other - Prefix:
Other - First Name:OLUWANBE
Other - Middle Name:IDOWU
Other - Last Name:OLAGUNDOYE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1052 KAREN BLVD
Mailing Address - Street 2:
Mailing Address - City:CAPITOL HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20743-4602
Mailing Address - Country:US
Mailing Address - Phone:240-604-1558
Mailing Address - Fax:
Practice Address - Street 1:1001 LAWRENCE ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-3513
Practice Address - Country:US
Practice Address - Phone:240-604-1558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-30
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health