Provider Demographics
NPI:1821729443
Name:OLOWE, TAIWO ADENIKE
Entity Type:Individual
Prefix:MRS
First Name:TAIWO
Middle Name:ADENIKE
Last Name:OLOWE
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 1:605 AVIS DR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-2283
Mailing Address - Country:US
Mailing Address - Phone:202-415-7509
Mailing Address - Fax:
Practice Address - Street 1:12200 PLUM ORCHARD DR STE 120
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-7843
Practice Address - Country:US
Practice Address - Phone:240-597-9950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-23
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician