Provider Demographics
NPI:1801592191
Name:OLDS, DYONA
Entity type:Individual
Prefix:
First Name:DYONA
Middle Name:
Last Name:OLDS
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 1:1248 S WESTCHESTER ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53214-3647
Mailing Address - Country:US
Mailing Address - Phone:414-394-5585
Mailing Address - Fax:
Practice Address - Street 1:1248 S WESTCHESTER ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53214-3647
Practice Address - Country:US
Practice Address - Phone:414-394-5585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator