Provider Demographics
NPI:1912634676
Name:CHAPPOTIN, OLGA LIDIA
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:LIDIA
Last Name:CHAPPOTIN
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 1:3880 23RD AVE SW
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34117-6654
Mailing Address - Country:US
Mailing Address - Phone:786-362-1328
Mailing Address - Fax:
Practice Address - Street 1:4019 22ND AVE NE
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34120-8965
Practice Address - Country:US
Practice Address - Phone:786-362-1328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-03
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL22-221695106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician