Provider Demographics
NPI:1346973161
Name:OLIA, NEZHAT (LGPC)
Entity Type:Individual
Prefix:DR
First Name:NEZHAT
Middle Name:
Last Name:OLIA
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:828 DULANEY VALLEY RD STE 7
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2822
Mailing Address - Country:US
Mailing Address - Phone:410-870-0490
Mailing Address - Fax:
Practice Address - Street 1:828 DULANEY VALLEY RD STE 7
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2822
Practice Address - Country:US
Practice Address - Phone:410-870-0490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-08
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP10438101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional