Adegoroye, Boladale Wuraola

Adegoroye, Boladale Wuraola is an sole proprietor health care provider with primary practice located at 768 Duvall Hwy , Pasadena MD 21122-1620. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Adegoroye, Boladale Wuraola can be contacted via phone (240) 481-9962.

Contact Information

Primary practice address
768 Duvall Hwy Pasadena MD 21122-1620
Phone: (240) 481-9962
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X LC7193 Maryland
Behavioral Health & Social Service Providers / Professional 101YP2500X LC7193 Maryland
Behavioral Health & Social Service Providers / Mental Health 101YM0800X LC7193 Maryland

Profile Details

NPI number 1790174506
LBN Legal business name Adegoroye, Boladale Wuraola
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 16th, 2015
Last updated Feb 23rd, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790174506 NPPES
Maryland MEDICAID 1155938 00

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