Provider Demographics
NPI:1033494323
Name:ADEYEMO, DORCAS AYOBAMI (MED GUIDANCE & COUN)
Entity Type:Individual
Prefix:MS
First Name:DORCAS
Middle Name:AYOBAMI
Last Name:ADEYEMO
Suffix:
Gender:F
Credentials:MED GUIDANCE & COUN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8319 LIBERTY RD
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-3127
Mailing Address - Country:US
Mailing Address - Phone:443-621-6235
Mailing Address - Fax:410-701-7375
Practice Address - Street 1:8319 LIBERTY RD
Practice Address - Street 2:
Practice Address - City:WINDSOR MILL
Practice Address - State:MD
Practice Address - Zip Code:21244-3127
Practice Address - Country:US
Practice Address - Phone:443-621-6235
Practice Address - Fax:410-701-7375
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-18
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR3036372600000X, 374U00000X
374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No372600000XNursing Service Related ProvidersAdult Companion