Provider Demographics
NPI:1730727363
Name:OSUOFA, FLORENCE O (LPC)
Entity type:Individual
Prefix:
First Name:FLORENCE
Middle Name:O
Last Name:OSUOFA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:FLORENCE
Other - Middle Name:O
Other - Last Name:OSUOFA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:3636 N MACARTHUR BLVD STE 160
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-3601
Mailing Address - Country:US
Mailing Address - Phone:940-703-3547
Mailing Address - Fax:
Practice Address - Street 1:3636 N MACARTHUR BLVD STE 160
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-3601
Practice Address - Country:US
Practice Address - Phone:940-703-3547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-13
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72582101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health