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General NPI Number Information
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NPI Number | 1902178593
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Entity Type | Individual
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Provider Name | GAIL REGINA OLIVEIRA LPC
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Gender | Female
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Dates
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Enumeration Date | 01/30/2012
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Last Update Date | 08/28/2013
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Provider Practice Location Address
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Address Line | 1218 FAIRBURN RD SW SUITE 102
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City | ATLANTA
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State | GA
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Zip | 30331-2117
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Country | US
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Telephone | 678-773-5838
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Fax | 404-883-2210
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Provider Business Mailing Address
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Address Line | 326 PEAKS LNDG
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City | CONYERS
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State | GA
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Zip | 30013-5055
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Country | US
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Telephone | 678-773-5838
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Fax | 404-883-2210
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC006686
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License Number State | GA
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