Provider Demographics
NPI:1821335316
Name:SOKOYA, OMOBOLA DENISE
Entity Type:Individual
Prefix:MRS
First Name:OMOBOLA
Middle Name:DENISE
Last Name:SOKOYA
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:OMOBOLA
Other - Middle Name:DENISE
Other - Last Name:OSUNFISAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9801 GOOD LUCK RD
Mailing Address - Street 2:8
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3352
Mailing Address - Country:US
Mailing Address - Phone:240-405-0186
Mailing Address - Fax:240-394-4868
Practice Address - Street 1:9801 GOOD LUCK RD
Practice Address - Street 2:8
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3352
Practice Address - Country:US
Practice Address - Phone:240-405-0186
Practice Address - Fax:240-394-4868
Is Sole Proprietor?:No
Enumeration Date:2013-01-03
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide