Provider Demographics
NPI:1417211038
Name:OLLILA, ANNIE DILLON (MSW LICSW)
Entity Type:Individual
Prefix:MS
First Name:ANNIE
Middle Name:DILLON
Last Name:OLLILA
Suffix:
Gender:F
Credentials:MSW LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 LOCKE RD
Mailing Address - Street 2:
Mailing Address - City:RUTLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01543-2047
Mailing Address - Country:US
Mailing Address - Phone:508-849-5600
Mailing Address - Fax:508-865-3511
Practice Address - Street 1:51 UNION ST
Practice Address - Street 2:222
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1194
Practice Address - Country:US
Practice Address - Phone:508-317-2323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-28
Last Update Date:2016-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2173201041C0700X
MA1178651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical