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General NPI Number Information
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NPI Number | 1457700965
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Entity Type | Individual
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Provider Name | OLIVIA GREY
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Gender | Female
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Dates
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Enumeration Date | 06/06/2016
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 6955 PORTWEST DR STE 190
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City | HOUSTON
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State | TX
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Zip | 77024-8051
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Country | US
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Telephone | 281-800-1020
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Fax |
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Provider Business Mailing Address
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Address Line | 2209 PORTOFINO PL UNIT 2525
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City | PALM HARBOR
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State | FL
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Zip | 34683-7741
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-21-47799
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License Number State | FL
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