Provider Demographics
NPI:1871262097
Name:OLOYEDE, ONYEKA THERESATONETTE
Entity Type:Individual
Prefix:
First Name:ONYEKA
Middle Name:THERESATONETTE
Last Name:OLOYEDE
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 1:6903 GREENBORO LN
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-1511
Mailing Address - Country:US
Mailing Address - Phone:240-938-2118
Mailing Address - Fax:
Practice Address - Street 1:5400 SHAWNEE RD STE 208
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22312-2300
Practice Address - Country:US
Practice Address - Phone:703-750-0633
Practice Address - Fax:703-997-7539
Is Sole Proprietor?:No
Enumeration Date:2021-09-10
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician