Provider Demographics
NPI:1467323600
Name:OJO, OLUSEUN DETUTU (CNA, HHA, CMT)
Entity type:Individual
Prefix:
First Name:OLUSEUN
Middle Name:DETUTU
Last Name:OJO
Suffix:
Gender:M
Credentials:CNA, HHA, CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6492 LANDOVER RD STE C8
Mailing Address - Street 2:
Mailing Address - City:CHEVERLY
Mailing Address - State:MD
Mailing Address - Zip Code:20785-1455
Mailing Address - Country:US
Mailing Address - Phone:442-682-3773
Mailing Address - Fax:000-000-0000
Practice Address - Street 1:6492 LANDOVER RD STE C8
Practice Address - Street 2:
Practice Address - City:CHEVERLY
Practice Address - State:MD
Practice Address - Zip Code:20785-1455
Practice Address - Country:US
Practice Address - Phone:442-682-3773
Practice Address - Fax:000-000-0000
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-12
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00204332376K00000X
DCHHA200005380374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide