Provider Demographics
NPI:1942763487
Name:OLDANI, JOHN JOSEPH (MS, NCSP)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:JOSEPH
Last Name:OLDANI
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Gender:M
Credentials:MS, NCSP
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Mailing Address - Street 1:BASSC - BELLEVILLE AREA SPECIAL SERVICES COOPERATIVE
Mailing Address - Street 2:2411 PATHWAYS CROSSING
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62221
Mailing Address - Country:US
Mailing Address - Phone:618-355-4700
Mailing Address - Fax:618-355-4415
Practice Address - Street 1:BASSC - BELLEVILLE AREA SPECIAL SERVICES COOPERATIVE
Practice Address - Street 2:2411 PATHWAYS CROSSING
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62221
Practice Address - Country:US
Practice Address - Phone:618-355-4700
Practice Address - Fax:618-355-4415
Is Sole Proprietor?:No
Enumeration Date:2019-04-11
Last Update Date:2019-04-11
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool