Provider Demographics
NPI:1942975370
Name:DE OLIVEIRA, LEIDIANE ALMEIDA
Entity Type:Individual
Prefix:
First Name:LEIDIANE
Middle Name:ALMEIDA
Last Name:DE OLIVEIRA
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 1:10 DRESSER ST APT 4
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:RI
Mailing Address - Zip Code:02840-3693
Mailing Address - Country:US
Mailing Address - Phone:401-207-7235
Mailing Address - Fax:
Practice Address - Street 1:92 UNION SQ
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143-3028
Practice Address - Country:US
Practice Address - Phone:617-764-2091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-09
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health