Provider Demographics
NPI:1407573728
Name:ONI, OLUWATOFUNMI (PSYD)
Entity Type:Individual
Prefix:
First Name:OLUWATOFUNMI
Middle Name:
Last Name:ONI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:MRS
Other - First Name:OLUWATOFUNMI
Other - Middle Name:
Other - Last Name:ONI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:1013 BEARDS HILL RD STE 101M3291
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:MD
Mailing Address - Zip Code:21001-2293
Mailing Address - Country:US
Mailing Address - Phone:443-203-9006
Mailing Address - Fax:
Practice Address - Street 1:2542 ADMIRAL LN
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-1488
Practice Address - Country:US
Practice Address - Phone:609-230-9121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-26
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06752103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical