Provider Demographics
NPI:1760241798
Name:SALLEMI, OLIVIA F
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:F
Last Name:SALLEMI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 W THOMPSON LN APT N105
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-3625
Mailing Address - Country:US
Mailing Address - Phone:615-440-6709
Mailing Address - Fax:
Practice Address - Street 1:4005 CEDAR GLADES DRIVE
Practice Address - Street 2:UNIT A
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37128
Practice Address - Country:US
Practice Address - Phone:615-285-9362
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRBT-23-301242106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician