Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 79478 | TX |
NPI | 1003307133 |
---|---|
Provider Name | Yemi Lekuti |
First Address | Dallas, TX 75254-7564 |
Second Address | Dallas, TX 75254-7564 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2018 |
Last Update Date | 24/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
79478 | (05) | TX |