Provider Information for 1639369341
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OLGA CARMEN ELISE PISCHEDDA LPC
Sex: Female
NPI: 1639369341
Last Updated: 2021-10-21
Certification Date: 2021-10-16
Certification Date: 2021-10-16
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1639369341 | ||||||||||||
| Enumeration Date | 2007-07-29 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 207 S CZECH HALL RD YUKON, OK 73099-6851 United States Phone: 405-492-1113 | Fax: | ||||||||||||
| Primary Practice Address | 13301 N MERIDIAN STE 100 OKLAHOMA CITY, OK 73120 United States Phone: 405-752-9500 | Fax:405-752-9571 | ||||||||||||
| Secondary Practice Address(es) | 13301 N MERIDIAN AVE 207 S CZECH HALL RD | ||||||||||||
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