Individual
TIA SHARDAE AYO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12770 COIT RD STE 870, DALLAS, TX 75251-1455
(972) 756-0500
(972) 765-0448
Mailing address
12770 COIT RD STE 870, DALLAS, TX 75251-1455
(972) 756-0500
(972) 765-0448
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
2355S0801X
Speech-Language Assistant
Primary
42956
TX
Other
Enumeration date
11/08/2018
Last updated
12/30/2022
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