MEDICARE: OLUWAYIMIKA BOLU JOSEPH

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	101YM0800X	Mental Health Counselor		TX

General Provider Information

NPI Number	:	1174467062
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLUWAYIMIKA BOLU JOSEPH

Provider Business Mailing Address
First Line	:	6039 SETTLERS VILLAGE DR
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77449-6555
Country	:	US
Telephone Number	:	832-899-1627
Fax Number	:

Provider Business Practice Location Address
First Line	:	6039 SETTLERS VILLAGE DR
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77449-6555
Country	:	US
Telephone Number	:	832-899-1627
Fax Number	:

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

Provider Enumeration Date	:	04/20/2026
Last Update Date	:	04/20/2026

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