Provider Demographics
NPI:1013378009
Name:ACREE, OLIVIA (EDS)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:ACREE
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8605 SELDONDALE LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-7241
Mailing Address - Country:US
Mailing Address - Phone:804-402-8426
Mailing Address - Fax:
Practice Address - Street 1:8719 FOREST HILL AVE
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-2431
Practice Address - Country:US
Practice Address - Phone:804-402-8426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-17
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0803000254103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool