Provider Demographics
NPI:1700026630
Name:OLAH, MELISA DAWN (CM)
Entity Type:Individual
Prefix:
First Name:MELISA
Middle Name:DAWN
Last Name:OLAH
Suffix:
Gender:F
Credentials:CM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:748 E ROSE DR
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73110-7928
Mailing Address - Country:US
Mailing Address - Phone:405-455-1764
Mailing Address - Fax:
Practice Address - Street 1:2512 S HARVEY AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73109-5958
Practice Address - Country:US
Practice Address - Phone:405-810-9578
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-05
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker