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Organization

PRACTICAL LIFE HEALTH SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
OLAYEMI AYILEGBE (DNP, PMHNP)
(667) 842-1003
Entity
Organization

Contact information

Practice address
1013 CORTANA CT, SEVERN, MD 21144-1185
(667) 842-1003
Mailing address
1013 CORTANA CT, SEVERN, MD 21144-1185
(667) 842-1003

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary

Other

Enumeration date
11/09/2022
Last updated
11/09/2022
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