Provider Demographics
NPI:1821820234
Name:TARIBO, ODIEPRIYE JOEL (MA)
Entity type:Individual
Prefix:MR
First Name:ODIEPRIYE
Middle Name:JOEL
Last Name:TARIBO
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8401 MAYLAND DR STE A
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23294-4648
Mailing Address - Country:US
Mailing Address - Phone:240-654-2068
Mailing Address - Fax:
Practice Address - Street 1:107 CARPENTER DR STE 110
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20164-4468
Practice Address - Country:US
Practice Address - Phone:703-297-4368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health