Individual
ISMAILA KOLAWOLE ODUBENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4651 PEBBLESHIRE CT, WALDORF, MD 20602-4108
(240) 606-4620
Mailing address
1705 SHAMROCK AVE, CAPITOL HEIGHTS, MD 20743-5302
(240) 606-4620
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
DC
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
04/05/2012
Last updated
09/20/2018
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