Provider Demographics
NPI:1336031509
Name:KAYODE-ONIFADE, OMOSHALEWA
Entity type:Individual
Prefix:
First Name:OMOSHALEWA
Middle Name:
Last Name:KAYODE-ONIFADE
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 1:3434 CARRIAGE HILL CIR APT 101
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-6004
Mailing Address - Country:US
Mailing Address - Phone:443-741-5509
Mailing Address - Fax:443-741-5509
Practice Address - Street 1:9000 GARTH RD APT 204
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-7177
Practice Address - Country:US
Practice Address - Phone:443-870-0733
Practice Address - Fax:443-870-0733
Is Sole Proprietor?:No
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician