Provider Demographics
NPI:1003668427
Name:COKER, MARIAM OLUWATOYINADUKE (LGSW)
Entity Type:Individual
Prefix:
First Name:MARIAM
Middle Name:OLUWATOYINADUKE
Last Name:COKER
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3908 WARNER AVE
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20784-2001
Mailing Address - Country:US
Mailing Address - Phone:240-906-7724
Mailing Address - Fax:
Practice Address - Street 1:3908 WARNER AVE
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20784-2001
Practice Address - Country:US
Practice Address - Phone:240-906-7724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLG200002854104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker