Provider Demographics
NPI:1609231224
Name:ORAEFO, ZAKIYA MARYAM (PHDC, MSHS, MSC)
Entity Type:Individual
Prefix:
First Name:ZAKIYA
Middle Name:MARYAM
Last Name:ORAEFO
Suffix:
Gender:F
Credentials:PHDC, MSHS, MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 14TH ST APT 2502
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-7064
Mailing Address - Country:US
Mailing Address - Phone:727-528-3919
Mailing Address - Fax:
Practice Address - Street 1:3535 14TH ST APT 2502
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-7064
Practice Address - Country:US
Practice Address - Phone:972-752-8391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-24
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 174H00000X, 251K00000X
TX26D2106942247ZC0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physician
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No174H00000XOther Service ProvidersHealth Educator
No251K00000XAgenciesPublic Health or Welfare