Provider Demographics
NPI:1710686662
Name:ADESOTE, FUNMILOLA YEMISI (COMMUNITY SUPPORT)
Entity Type:Individual
Prefix:MRS
First Name:FUNMILOLA
Middle Name:YEMISI
Last Name:ADESOTE
Suffix:
Gender:F
Credentials:COMMUNITY SUPPORT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8912 WOODSTOCK DR W
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-5135
Mailing Address - Country:US
Mailing Address - Phone:240-478-2726
Mailing Address - Fax:
Practice Address - Street 1:4130 HUNT PL NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-3565
Practice Address - Country:US
Practice Address - Phone:202-388-4300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker