Provider Demographics
NPI:1659935617
Name:SANGODEYI, AKINDELE
Entity Type:Individual
Prefix:
First Name:AKINDELE
Middle Name:
Last Name:SANGODEYI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10979 BASKERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136-6415
Mailing Address - Country:US
Mailing Address - Phone:443-761-8685
Mailing Address - Fax:
Practice Address - Street 1:10979 BASKERVILLE RD
Practice Address - Street 2:
Practice Address - City:REISTERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21136-6415
Practice Address - Country:US
Practice Address - Phone:443-761-8685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-25
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD189291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical