Individual
SAMMY O AYODELE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1440 CARROLLTON PKWY APT 16201, CARROLLTON, TX 75010-1367
(336) 471-3394
Mailing address
1440 CARROLLTON PKWY APT 16201, CARROLLTON, TX 75010-1367
(336) 471-3394
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
305S00000X
Point of Service
—
—
311ZA0620X
Adult Care Home Facility
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
12/05/2019
Last updated
12/08/2019
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