Basic Information
| Provider Information | |||||||||
| NPI: | 1275022550 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ANARUWE | ||||||||
| FirstName: | OLUSOLA | ||||||||
| MiddleName: | MOTUNRAYO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3430 DODGE PARK ROAD APT 204 | ||||||||
| Address2: | |||||||||
| City: | HYATTSVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 20785 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2407149906 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2512 24TH STREET | ||||||||
| Address2: | |||||||||
| City: | NORTHEAST | ||||||||
| State: | DC | ||||||||
| PostalCode: | 20118 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2028328340 | ||||||||
| FaxNumber: | 2028328341 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2018 | ||||||||
| LastUpdateDate: | 06/16/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TH0100X | Y | Behavioral Health & Social Service Providers | Psychologist | Health Service |
No ID Information.