Provider Demographics
NPI:1225775943
Name:AJONGBOLO, SEUN (MBA)
Entity Type:Individual
Prefix:
First Name:SEUN
Middle Name:
Last Name:AJONGBOLO
Suffix:
Gender:M
Credentials:MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1829 REISTERSTOWN RD STE 350
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-7126
Mailing Address - Country:US
Mailing Address - Phone:443-401-4310
Mailing Address - Fax:
Practice Address - Street 1:1829 REISTERSTOWN RD STE 350
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-7126
Practice Address - Country:US
Practice Address - Phone:443-401-4310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-14
Last Update Date:2022-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health