Provider Demographics
NPI:1356942544
Name:IBITOYE, ABIGAIL (LPCA)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:IBITOYE
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6300 RIDGLEA PL STE 425
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76116-5704
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6300 RIDGLEA PL STE 425
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76116-5704
Practice Address - Country:US
Practice Address - Phone:682-224-7500
Practice Address - Fax:682-224-7501
Is Sole Proprietor?:No
Enumeration Date:2020-11-04
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health