Provider Demographics
NPI:1700585809
Name:ADETOLA, JANET (PMHNP)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:ADETOLA
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 W PADONIA RD STE C252
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE TIMONIUM
Mailing Address - State:MD
Mailing Address - Zip Code:21093-2241
Mailing Address - Country:US
Mailing Address - Phone:410-672-7028
Mailing Address - Fax:410-701-3742
Practice Address - Street 1:22 W PADONIA RD STE C252
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-2241
Practice Address - Country:US
Practice Address - Phone:410-672-7028
Practice Address - Fax:410-701-3742
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-27
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR177408363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health