Provider Demographics
NPI:1427341569
Name:MCGILL, OLIVIA DENISE (PHD)
Entity type:Individual
Prefix:DR
First Name:OLIVIA
Middle Name:DENISE
Last Name:MCGILL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3115 WICHITA ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-7764
Mailing Address - Country:US
Mailing Address - Phone:832-567-2985
Mailing Address - Fax:
Practice Address - Street 1:12000 WESTHEIMER RD
Practice Address - Street 2:SUITE 210
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-6681
Practice Address - Country:US
Practice Address - Phone:713-396-2985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-23
Last Update Date:2011-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35176103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist