Provider Demographics
NPI:1003580119
Name:ATTEBERY, OLGA ANASTASIA (LAPC)
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:ANASTASIA
Last Name:ATTEBERY
Suffix:
Gender:F
Credentials:LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 W PONCE DE LEON AVE STE 370
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-2476
Mailing Address - Country:US
Mailing Address - Phone:770-954-5476
Mailing Address - Fax:
Practice Address - Street 1:315 W PONCE DE LEON AVE STE 370
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-2476
Practice Address - Country:US
Practice Address - Phone:770-954-5476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-03
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist