Provider Demographics
NPI:1144508003
Name:OGUNTODU, OLANIKE MARY
Entity type:Individual
Prefix:MRS
First Name:OLANIKE
Middle Name:MARY
Last Name:OGUNTODU
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 1:2211 NORFOLK ST
Mailing Address - Street 2:SUITE 505
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-4096
Mailing Address - Country:US
Mailing Address - Phone:713-628-4452
Mailing Address - Fax:
Practice Address - Street 1:2211 NORFOLK ST
Practice Address - Street 2:SUITE 505
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-4096
Practice Address - Country:US
Practice Address - Phone:713-628-4452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-26
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical