Provider Demographics
NPI:1225335003
Name:HUFF, OLIVIA MARIE (CMP)
Entity Type:Individual
Prefix:MS
First Name:OLIVIA
Middle Name:MARIE
Last Name:HUFF
Suffix:
Gender:F
Credentials:CMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5137 ROBERTSON AVE
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-3660
Mailing Address - Country:US
Mailing Address - Phone:916-484-0606
Mailing Address - Fax:
Practice Address - Street 1:5137 ROBERTSON AVE
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-3660
Practice Address - Country:US
Practice Address - Phone:916-484-0606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-14
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16860225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist