Provider Demographics
NPI:1568158970
Name:ADELUSI, KEHINDE BOSEDE
Entity type:Individual
Prefix:
First Name:KEHINDE
Middle Name:BOSEDE
Last Name:ADELUSI
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 1:16963 SANGIOVESE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-3439
Mailing Address - Country:US
Mailing Address - Phone:229-296-8366
Mailing Address - Fax:
Practice Address - Street 1:16963 SANGIOVESE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-3439
Practice Address - Country:US
Practice Address - Phone:229-296-8366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-18
Last Update Date:2024-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX94814101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional