MEDICARE: ELIZABETH O AYORINDE

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

General Provider Information

NPI Number	:	1376708065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH O AYORINDE

Provider Business Mailing Address
First Line	:	1421 ATKINS ST
Second Line	:
City	:	CEDAR HILL
State	:	TX
Zip	:	75104-8121
Country	:	US
Telephone Number	:	214-715-5725
Fax Number	:	972-291-3176

Provider Business Practice Location Address
First Line	:	1421 ATKINS ST
Second Line	:
City	:	CEDAR HILL
State	:	TX
Zip	:	75104-8121
Country	:	US
Telephone Number	:	214-715-5725
Fax Number	:	972-291-3176

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

Provider Enumeration Date	:	07/23/2008
Last Update Date	:	07/23/2008

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