Provider Demographics
NPI:1013618693
Name:ONIFADE, FOLAKEMI ABIMBOLA
Entity Type:Individual
Prefix:
First Name:FOLAKEMI
Middle Name:ABIMBOLA
Last Name:ONIFADE
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 1:12029 QUARUM PL
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-4382
Mailing Address - Country:US
Mailing Address - Phone:443-454-3880
Mailing Address - Fax:
Practice Address - Street 1:12029 QUARUM PL
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-4382
Practice Address - Country:US
Practice Address - Phone:443-454-3880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No251B00000XAgenciesCase Management