Provider Demographics
NPI:1710705652
Name:O'NAIKE, ADETOLA
Entity type:Individual
Prefix:
First Name:ADETOLA
Middle Name:
Last Name:O'NAIKE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1624 BLUESTONE ST APT C
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MD
Mailing Address - Zip Code:21076-1958
Mailing Address - Country:US
Mailing Address - Phone:346-270-9099
Mailing Address - Fax:
Practice Address - Street 1:1624 BLUESTONE ST APT C
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MD
Practice Address - Zip Code:21076-1958
Practice Address - Country:US
Practice Address - Phone:346-270-9099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker