Provider Demographics
NPI:1780372128
Name:ALADELOYE, OLATIMBO REBECCAH (PMHNP)
Entity type:Individual
Prefix:
First Name:OLATIMBO
Middle Name:REBECCAH
Last Name:ALADELOYE
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10502 FOUNTAIN LAKE DR APT 933
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-3722
Mailing Address - Country:US
Mailing Address - Phone:832-887-7124
Mailing Address - Fax:
Practice Address - Street 1:2703 HIGHWAY 6 S STE 193
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-1759
Practice Address - Country:US
Practice Address - Phone:832-887-7124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1116332363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health