| Provider / Organization | NPI | Date Certified |
|---|---|---|
| JAIME TAVONIA OLIDGE | 1699098723 | 2023-02-11 |
Jaime Tavonia Olidge is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1699098723. Registration indicates Jaime Tavonia Olidge is a provider of access to substance use disorder providers services with a specialization in Behavioral Health & Social Service Providers, Counselor (Behavioral Health & Social Service Providers, Counselor) (Counselor: Addiction (Substance Use Disorder),, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Counselor Addiction Substance Use Disorder, Behavioral Health & Social Service Providers) (Counselor, ) Access to Mental Health/Behavioral Health Providers (Behavioral Health & Social Service Providers, Counselor) (Behavioral Health & Social Service Providers, Counselor) (Counselor: Professional, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Counselor Professional, Behavioral Health & Social Service Providers) (Counselor, )
| Entity Type | Individual |
| Provider Name | Ms. Jaime Tavonia Olidge LPC-A |
| Practice Office Address | 2911 A W GRIMES BLVD STE 330 PFLUGERVILLE, TX US |
| Practice Office Telephone | 6173790496 |
| Mailing Address | 2911 A W GRIMES BLVD STE 330 PFLUGERVILLE, TX 786601979 US |
| Business Telephone | 6173790496 |
| Code | Practice | License No State |
|---|---|---|
| 101YA0400X | Access to Substance Use Disorder Providers Behavioral Health & Social Service Providers Counselor Behavioral Health & Social Service Providers Counselor Counselor: Addiction (Substance Use Disorder), Behavioral Health/Substance Abuse/Psychiatry Counselor Addiction Substance Use Disorder Behavioral Health & Social Service Providers Counselor | |
| 101YP2500X PRIMARY | Access to Mental Health/Behavioral Health Providers Behavioral Health & Social Service Providers Counselor Behavioral Health & Social Service Providers Counselor Counselor: Professional Behavioral Health/Substance Abuse/Psychiatry Counselor Professional Behavioral Health & Social Service Providers Counselor | 88323
TX |