Provider Demographics
NPI:1417774142
Name:ARTNER, OLIVIA CATHERINE
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:CATHERINE
Last Name:ARTNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1881 AIRPORT FWY APT 112
Mailing Address - Street 2:
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76040-4059
Mailing Address - Country:US
Mailing Address - Phone:513-602-4027
Mailing Address - Fax:
Practice Address - Street 1:4831 MERLOT AVE
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-7383
Practice Address - Country:US
Practice Address - Phone:817-717-8584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician