Provider Demographics
NPI:1255793394
Name:MAJEKODUNMI, BOLANLE AMINAT (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:BOLANLE
Middle Name:AMINAT
Last Name:MAJEKODUNMI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:BOLANLE
Other - Middle Name:AMINAT
Other - Last Name:ONIGBANJO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:10502 FLORAL DR
Mailing Address - Street 2:
Mailing Address - City:ADELPHI
Mailing Address - State:MD
Mailing Address - Zip Code:20783-1227
Mailing Address - Country:US
Mailing Address - Phone:773-220-5015
Mailing Address - Fax:
Practice Address - Street 1:3227 BEL PRE RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-2423
Practice Address - Country:US
Practice Address - Phone:301-871-2000
Practice Address - Fax:301-871-2031
Is Sole Proprietor?:No
Enumeration Date:2016-03-28
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07170225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist