Provider Demographics
NPI:1750099677
Name:AKINLOTAN-WILLIAMS, OMOWUMI FOLAYEMI
Entity type:Individual
Prefix:
First Name:OMOWUMI
Middle Name:FOLAYEMI
Last Name:AKINLOTAN-WILLIAMS
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 1:10432 BALLS FORD RD STE 300
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20109-2517
Mailing Address - Country:US
Mailing Address - Phone:703-786-9297
Mailing Address - Fax:
Practice Address - Street 1:10432 BALLS FORD RD STE 300
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-2517
Practice Address - Country:US
Practice Address - Phone:571-532-8658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-09
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701011083101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional