Provider Demographics
NPI:1275022550
Name:ANARUWE, OLUSOLA MOTUNRAYO
Entity Type:Individual
Prefix:
First Name:OLUSOLA
Middle Name:MOTUNRAYO
Last Name:ANARUWE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3430 DODGE PARK ROAD APT 204
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20785
Mailing Address - Country:US
Mailing Address - Phone:240-714-9906
Mailing Address - Fax:
Practice Address - Street 1:2512 24TH STREET
Practice Address - Street 2:
Practice Address - City:NORTHEAST
Practice Address - State:DC
Practice Address - Zip Code:20118
Practice Address - Country:US
Practice Address - Phone:202-832-8340
Practice Address - Fax:202-832-8341
Is Sole Proprietor?:No
Enumeration Date:2018-05-02
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service