Provider Demographics
NPI:1669656989
Name:OGLETREE, CONNIE LYNN (CMHP,MBA)
Entity Type:Individual
Prefix:
First Name:CONNIE
Middle Name:LYNN
Last Name:OGLETREE
Suffix:
Gender:F
Credentials:CMHP,MBA
Other - Prefix:
Other - First Name:CONNIE
Other - Middle Name:OGLETREE
Other - Last Name:GAFFNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MBA
Mailing Address - Street 1:200 AVENUE F NE
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33881-4131
Mailing Address - Country:US
Mailing Address - Phone:863-293-1121
Mailing Address - Fax:863-291-6084
Practice Address - Street 1:1201 FIRST STREET SOUTH
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33881
Practice Address - Country:US
Practice Address - Phone:863-293-1121
Practice Address - Fax:863-291-6084
Is Sole Proprietor?:No
Enumeration Date:2007-12-21
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator