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General NPI Number Information
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NPI Number | 1841012564
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Entity Type | Organization
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Legal Business Name | OLIFANT THERAPEUTIC SERVICES & CONSULTING
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Dates
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Enumeration Date | 10/25/2024
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Last Update Date | 10/25/2024
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Provider Practice Location Address
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Address Line | 7606 BAYFIELD DR
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City | TINLEY PARK
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State | IL
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Zip | 60487-5535
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Country | US
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Telephone | 815-546-5112
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Fax |
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Provider Business Mailing Address
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Address Line | 7606 BAYFIELD DR
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City | TINLEY PARK
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State | IL
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Zip | 60487-5535
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Country | US
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Telephone | 815-546-5112
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KRISTINA LABRIOLA
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Credential | LCSW
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Telephone | 815-546-5112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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