Provider Demographics
NPI:1861808305
Name:ODUFUWA, ESTHER AYOTUNDE
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:AYOTUNDE
Last Name:ODUFUWA
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 1:130 CANAL ST
Mailing Address - Street 2:APT. 812
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02721-1404
Mailing Address - Country:US
Mailing Address - Phone:508-933-0700
Mailing Address - Fax:
Practice Address - Street 1:130 CANAL ST
Practice Address - Street 2:APT. 812
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721-1404
Practice Address - Country:US
Practice Address - Phone:508-933-0700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-04
Last Update Date:2014-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health