Provider Demographics
NPI:1497430649
Name:ALASOADURA, HELEN OLAMIDE
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:OLAMIDE
Last Name:ALASOADURA
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 1:15819 ERWIN CT
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-2634
Mailing Address - Country:US
Mailing Address - Phone:240-593-7551
Mailing Address - Fax:
Practice Address - Street 1:15819 ERWIN CT
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-2634
Practice Address - Country:US
Practice Address - Phone:240-593-7551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-15
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
DC171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health