Provider Demographics
NPI:1639521529
Name:OLEWILER, LEAH (MS, CGC)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:OLEWILER
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216-4500
Mailing Address - Country:US
Mailing Address - Phone:601-899-2603
Mailing Address - Fax:
Practice Address - Street 1:2500 NORTH STATE ST
Practice Address - Street 2:C/O PEDIATRIC GENETICS
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216
Practice Address - Country:US
Practice Address - Phone:601-984-1001
Practice Address - Fax:601-984-1916
Is Sole Proprietor?:No
Enumeration Date:2016-07-05
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS