Provider Demographics
NPI:1912657305
Name:INFINITE MIND WELLNESS
Entity Type:Organization
Organization Name:INFINITE MIND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OLALEKAN
Authorized Official - Middle Name:
Authorized Official - Last Name:AJAYI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-925-9555
Mailing Address - Street 1:11513 LIPSCOMB WAY
Mailing Address - Street 2:
Mailing Address - City:WHITE MARSH
Mailing Address - State:MD
Mailing Address - Zip Code:21162-3425
Mailing Address - Country:US
Mailing Address - Phone:443-925-9555
Mailing Address - Fax:443-442-6903
Practice Address - Street 1:8606 HARFORD RD FL 2
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234-4657
Practice Address - Country:US
Practice Address - Phone:443-925-9555
Practice Address - Fax:443-442-6903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-28
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty