Provider Demographics
NPI:1245611938
Name:ADAMOH-FANIYAN, ISLAMIAT (SLP)
Entity Type:Individual
Prefix:
First Name:ISLAMIAT
Middle Name:
Last Name:ADAMOH-FANIYAN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2433 18TH PL SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-6315
Mailing Address - Country:US
Mailing Address - Phone:202-246-4833
Mailing Address - Fax:
Practice Address - Street 1:2433 18TH PL SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-6315
Practice Address - Country:US
Practice Address - Phone:202-246-4833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-18
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist