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Individual

GRACE AYANDIBU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D, M.S, LPC

Contact information

Practice address
2637 PLAZA PKWY, WICHITA FALLS, TX 76308-3889
(940) 239-9160
Mailing address
2637 PLAZA PKWY, WICHITA FALLS, TX 76308-3889
(940) 666-3060

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
178007242
IL
207NS0135X
Procedural Dermatology Physician
Primary
T9346
TX
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
11/08/2011
Last updated
04/10/2023
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