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General NPI Number Information
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NPI Number | 1710133285
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Entity Type | Individual
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Provider Name | OLIMPIA FIORE ETTS LCSW-C
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Gender | Female
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Dates
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Enumeration Date | 08/14/2008
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Last Update Date | 10/28/2010
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Provider Practice Location Address
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Address Line | 109 LA GRANGE AVE SUITE 102
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City | LA PLATA
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State | MD
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Zip | 20646-9592
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Country | US
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Telephone | 917-576-7237
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Fax |
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Provider Business Mailing Address
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Address Line | 6015 NEW FOREST CT APT. 5
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City | WALDORF
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State | MD
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Zip | 20603-4735
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Country | US
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Telephone | 917-576-7237
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 15217
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License Number State | MD
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