Provider Demographics
NPI:1447031463
Name:AKINWUNTAN, IDOWU
Entity type:Individual
Prefix:
First Name:IDOWU
Middle Name:
Last Name:AKINWUNTAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TENIOLA
Other - Middle Name:
Other - Last Name:AKINWUNTAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:715 INGLESIDE AVE
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-1726
Mailing Address - Country:US
Mailing Address - Phone:443-800-3188
Mailing Address - Fax:
Practice Address - Street 1:715 INGLESIDE AVE
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-1726
Practice Address - Country:US
Practice Address - Phone:443-800-3188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-06
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No225XH1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHuman Factors
No172V00000XOther Service ProvidersCommunity Health Worker
No224ZR0403XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantDriving and Community Mobility
No373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No225XM0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program