Provider Demographics
NPI:1386285765
Name:OLMI, DANNY J
Entity type:Individual
Prefix:
First Name:DANNY
Middle Name:J
Last Name:OLMI
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:JOE
Other - Middle Name:
Other - Last Name:OLMI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:126 BENT CRK
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-8474
Mailing Address - Country:US
Mailing Address - Phone:601-270-8639
Mailing Address - Fax:
Practice Address - Street 1:2510 LAKELAND TER
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4702
Practice Address - Country:US
Practice Address - Phone:601-982-7827
Practice Address - Fax:601-822-0303
Is Sole Proprietor?:No
Enumeration Date:2019-10-07
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS33-526103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent