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General NPI Number Information
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NPI Number | 1689074577
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Entity Type | Individual
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Provider Name | OLGA PANARINA PSYD
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Gender | Female
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Dates
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Enumeration Date | 08/27/2014
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Last Update Date | 06/08/2023
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Provider Practice Location Address
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Address Line | 1115 ELKTON DR STE 102
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City | COLORADO SPRINGS
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State | CO
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Zip | 80907-3597
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Country | US
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Telephone | 719-357-6471
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Fax |
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Provider Business Mailing Address
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Address Line | 7923 MOONDANCE TRL
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City | FOUNTAIN
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State | CO
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Zip | 80817-4306
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 092291
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6132
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License Number State | CO
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