Provider Demographics
NPI:1104237452
Name:AYOOLA, ZAINAB A, G
Entity type:Individual
Prefix:
First Name:ZAINAB
Middle Name:A, G
Last Name:AYOOLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13040 OLD STAGE COACH RD APT 112
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-1613
Mailing Address - Country:US
Mailing Address - Phone:240-646-2856
Mailing Address - Fax:
Practice Address - Street 1:2833 GEORGIA AVE NW # B1
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-3862
Practice Address - Country:US
Practice Address - Phone:202-588-8036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-08
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA10093374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide