Provider Demographics
NPI:1922587625
Name:CHRISTINE OGLESBY FAMILY THERAPY PLLC
Entity Type:Organization
Organization Name:CHRISTINE OGLESBY FAMILY THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:ELIXZABETH
Authorized Official - Last Name:OGLESBY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LMFT
Authorized Official - Phone:434-515-3510
Mailing Address - Street 1:7147 BRANDY HILL TER APT 202
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-4499
Mailing Address - Country:US
Mailing Address - Phone:434-515-3510
Mailing Address - Fax:
Practice Address - Street 1:7147 BRANDY HILL TER APT 202
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111
Practice Address - Country:US
Practice Address - Phone:434-515-3510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-13
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty