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General NPI Number Information
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NPI Number | 1932923083
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Entity Type | Individual
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Provider Name | OLIVIA SHEA BATSON
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Gender | Female
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Dates
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Enumeration Date | 11/14/2024
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | VIA GIORGIO CORBETTA, 17
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City | VICNEZA
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State | VICENZA
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Zip | 36100
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Country | IT
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Telephone | 44-461-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 8225 ADENLEE AVE APT 10
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City | FAIRFAX
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State | VA
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Zip | 22031-4825
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Country | US
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Telephone | 831-444-5712
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 0402208503
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License Number State | VA
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