Provider Demographics
NPI:1891109310
Name:FADIORA-ADEDIJI, OLAWUNMI (LCPC)
Entity Type:Individual
Prefix:
First Name:OLAWUNMI
Middle Name:
Last Name:FADIORA-ADEDIJI
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:OLAWUNMI
Other - Middle Name:
Other - Last Name:FADIORA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCPC
Mailing Address - Street 1:6707 WHITESTONE RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:GWYNN OAK
Mailing Address - State:MD
Mailing Address - Zip Code:21207-4106
Mailing Address - Country:US
Mailing Address - Phone:410-265-8737
Mailing Address - Fax:410-265-1258
Practice Address - Street 1:6707 WHITESTONE RD
Practice Address - Street 2:SUITE 106
Practice Address - City:GWYNN OAK
Practice Address - State:MD
Practice Address - Zip Code:21207-4106
Practice Address - Country:US
Practice Address - Phone:410-265-8737
Practice Address - Fax:410-265-1258
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-12
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC4936101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional