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Individual

TITILAYO AYENI-SODE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
23025 AMBER LN, RICHTON PARK, IL 60471-1281
(575) 442-6572
Mailing address
23025 AMBER LN, RICHTON PARK, IL 60471-1281

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043.126731
IL

Other

Enumeration date
08/24/2020
Last updated
03/03/2022
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