Provider Demographics
NPI:1720895840
Name:BABATUNDE-BROWN, OLAIDE
Entity type:Individual
Prefix:DR
First Name:OLAIDE
Middle Name:
Last Name:BABATUNDE-BROWN
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 1:629 E WOOD ST STE 205
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-3752
Mailing Address - Country:US
Mailing Address - Phone:856-839-0881
Mailing Address - Fax:856-839-4813
Practice Address - Street 1:629 E WOOD ST STE 205
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-3752
Practice Address - Country:US
Practice Address - Phone:856-839-0881
Practice Address - Fax:856-839-4813
Is Sole Proprietor?:No
Enumeration Date:2024-12-12
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician