Provider Demographics
NPI:1780110106
Name:AROWOLO, RACHAEL (PHD)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:
Last Name:AROWOLO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:RACHAEL
Other - Middle Name:
Other - Last Name:BOWLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:5316 DISNEY AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:MD
Mailing Address - Zip Code:21225-3143
Mailing Address - Country:US
Mailing Address - Phone:716-868-3979
Mailing Address - Fax:
Practice Address - Street 1:15245 SHADY GROVE RD STE 350
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6237
Practice Address - Country:US
Practice Address - Phone:301-765-5430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-04
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60608192106S00000X
390200000X
MD06909103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program