Provider Demographics
NPI:1295365781
Name:OJO, ESTHER OLUWAFOLASHADE (OTD, OTR/L)
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:OLUWAFOLASHADE
Last Name:OJO
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7585 KITTY HAWK STE 202
Mailing Address - Street 2:
Mailing Address - City:CONVERSE
Mailing Address - State:TX
Mailing Address - Zip Code:78109-2820
Mailing Address - Country:US
Mailing Address - Phone:210-236-0911
Mailing Address - Fax:210-899-0912
Practice Address - Street 1:7585 KITTY HAWK STE 202
Practice Address - Street 2:
Practice Address - City:CONVERSE
Practice Address - State:TX
Practice Address - Zip Code:78109-2820
Practice Address - Country:US
Practice Address - Phone:210-236-0911
Practice Address - Fax:210-899-0912
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-23
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120496225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist