Adijat Jassmia Agbo-Ola, M.ED

Individual provider Active NPI Professional Counselor · Capitol Heights, MD

NPI 1053762054 · NPPES record last updated Dec 15, 2023

Key facts

NPI
1053762054
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
Practice address
4204 Alton St
Capitol Heights, MD 20743-5802
Phone
(757) 753-7525
NPI assigned
Jun 30, 2016
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Education

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X Yes

Addresses

Primary practice location

4204 Alton St
Capitol Heights, MD 20743-5802

Mailing address

4204 Alton St
Capitol Heights, MD 20743-5802

Other identifiers

IdentifierTypeStateIssuer
LC13330OtherMDLCPC - MARYLAND COUNSELING LICENSE NUMBER

Other providers in Capitol Heights, MD

All providers in Capitol Heights, MD · Professional Counselor in Maryland

Sources for this page

Verify at the official NPI Registry.