Provider Demographics
NPI:1154033660
Name:IMI OLA
Entity type:Organization
Organization Name:IMI OLA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LICENSED CLINICAL PSYCHOLOGI
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:NAPOLI
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:808-646-1497
Mailing Address - Street 1:3955 FOOSHE AVE
Mailing Address - Street 2:
Mailing Address - City:MICCO
Mailing Address - State:FL
Mailing Address - Zip Code:32976-2940
Mailing Address - Country:US
Mailing Address - Phone:808-646-1497
Mailing Address - Fax:
Practice Address - Street 1:3955 FOOSHE AVE
Practice Address - Street 2:
Practice Address - City:MICCO
Practice Address - State:FL
Practice Address - Zip Code:32976-2940
Practice Address - Country:US
Practice Address - Phone:808-646-1497
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-15
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty