Provider Demographics
NPI:1740746627
Name:OGUNDIPE, SARA (RBT)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:OGUNDIPE
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8668 JOHN HICKMAN PKWY STE 1002
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-9388
Mailing Address - Country:US
Mailing Address - Phone:972-292-9469
Mailing Address - Fax:888-858-1552
Practice Address - Street 1:14285 MIDWAY RD STE 310
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-3622
Practice Address - Country:US
Practice Address - Phone:972-292-9469
Practice Address - Fax:888-858-1552
Is Sole Proprietor?:No
Enumeration Date:2019-02-15
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX90698101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1740746627OtherNPI