Provider Demographics
NPI:1861860702
Name:BABALOLA, OKWUDIRINNA ANITA
Entity type:Individual
Prefix:
First Name:OKWUDIRINNA
Middle Name:ANITA
Last Name:BABALOLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:OKWUDIRINNA
Other - Middle Name:
Other - Last Name:FINTAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5119 TERNBERRY FOREST LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-6961
Mailing Address - Country:US
Mailing Address - Phone:832-520-6898
Mailing Address - Fax:
Practice Address - Street 1:8118 FRY RD STE 803
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-7850
Practice Address - Country:US
Practice Address - Phone:281-215-3595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-09
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX392932355S0801X
TX8813103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant