Provider Demographics
NPI:1831544170
Name:OLAES, CHRISTINE (LING) (ATR-BC)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:(LING)
Last Name:OLAES
Suffix:
Gender:F
Credentials:ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3243 NORTHBROOK DR
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341-4627
Mailing Address - Country:US
Mailing Address - Phone:404-862-7203
Mailing Address - Fax:
Practice Address - Street 1:4549 CHAMBLEE DUNWOODY RD
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338-6210
Practice Address - Country:US
Practice Address - Phone:770-677-9398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-24
Last Update Date:2016-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA09-163221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist