Provider Demographics
NPI:1285036608
Name:BUTLER, OLIVIA BENOIT LAW
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:BENOIT LAW
Last Name:BUTLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 POND VIEW DR
Mailing Address - Street 2:
Mailing Address - City:VINEYARD HAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02568-3916
Mailing Address - Country:US
Mailing Address - Phone:508-326-9430
Mailing Address - Fax:
Practice Address - Street 1:101 POND VIEW DR
Practice Address - Street 2:
Practice Address - City:VINEYARD HAVEN
Practice Address - State:MA
Practice Address - Zip Code:02568-3916
Practice Address - Country:US
Practice Address - Phone:508-326-9430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor