Provider Demographics
NPI:1649959297
Name:OGUNSANYA, FOLAKE BERNADETTE
Entity type:Individual
Prefix:DR
First Name:FOLAKE
Middle Name:BERNADETTE
Last Name:OGUNSANYA
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 1:809 N HAMMONDS FERRY RD STE C
Mailing Address - Street 2:
Mailing Address - City:LINTHICUM HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:21090-1317
Mailing Address - Country:US
Mailing Address - Phone:130-150-2335
Mailing Address - Fax:
Practice Address - Street 1:809 N HAMMONDS FERRY RD STE C
Practice Address - Street 2:
Practice Address - City:LINTHICUM HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:21090-1317
Practice Address - Country:US
Practice Address - Phone:130-150-2335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR243709363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health