Provider Demographics
NPI:1285985580
Name:OGUNDELE, AJIBOLA ABODUNRIN (COTA)
Entity type:Individual
Prefix:MRS
First Name:AJIBOLA
Middle Name:ABODUNRIN
Last Name:OGUNDELE
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
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Mailing Address - Street 1:801 RICHMOND DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-6059
Mailing Address - Country:US
Mailing Address - Phone:972-839-3533
Mailing Address - Fax:214-338-2252
Practice Address - Street 1:801 RICHMOND DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-6059
Practice Address - Country:US
Practice Address - Phone:972-839-3533
Practice Address - Fax:214-338-2252
Is Sole Proprietor?:No
Enumeration Date:2012-09-26
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207818224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant