Individual
BENEDICTA IZEGBOYA SOBANJO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12004 POLLYANNA AVE UNIT B, AUSTIN, TX 78753-2242
(512) 998-3561
Mailing address
12004 POLLYANNA AVE UNIT B, AUSTIN, TX 78753-2242
(512) 998-3561
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
08/10/2022
Last updated
08/10/2022
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