MEDICARE: OLUFOLAKE IKE

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	106H00000X	Marriage & Family Therapist	203867	TX

General Provider Information

NPI Number	:	1043964240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLUFOLAKE IKE

Provider Business Mailing Address
First Line	:	8502 CAMBRIDGE ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-4003
Country	:	US
Telephone Number	:	832-671-2022
Fax Number	:

Provider Business Practice Location Address
First Line	:	8502 CAMBRIDGE ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-4003
Country	:	US
Telephone Number	:	832-671-2022
Fax Number	:

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

Provider Enumeration Date	:	02/07/2022
Last Update Date	:	02/07/2022

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Directions to “ OLUFOLAKE IKE ” Practice Location

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