Provider Demographics
NPI:1629208244
Name:ASEKUN, MOROLAYO O
Entity Type:Individual
Prefix:MRS
First Name:MOROLAYO
Middle Name:O
Last Name:ASEKUN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6316 BROOKCREST DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76018-2956
Mailing Address - Country:US
Mailing Address - Phone:817-881-2297
Mailing Address - Fax:817-419-0472
Practice Address - Street 1:6316 BROOKCREST DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76018-2956
Practice Address - Country:US
Practice Address - Phone:817-881-2297
Practice Address - Fax:817-419-0472
Is Sole Proprietor?:No
Enumeration Date:2009-07-16
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator