MEDICARE: SARAH OYEBAMIJI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician		TX

General Provider Information

NPI Number	:	1598407462
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH OYEBAMIJI

Provider Business Mailing Address
First Line	:	8350 PARK LN APT 213
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-0708
Country	:	US
Telephone Number	:	972-802-5735
Fax Number	:

Provider Business Practice Location Address
First Line	:	5085 W PARK BLVD STE 20075093
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-2593
Country	:	US
Telephone Number	:	972-665-8484
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2022
Last Update Date	:	04/11/2022

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Directions to “ SARAH OYEBAMIJI ” Practice Location

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