Provider Demographics
NPI:1952868705
Name:DE OLIVEIRA FERREIRA, LEONICE
Entity Type:Individual
Prefix:
First Name:LEONICE
Middle Name:
Last Name:DE OLIVEIRA FERREIRA
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 1:510 RICHMOND AVE APT 442
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-5582
Mailing Address - Country:US
Mailing Address - Phone:781-454-8499
Mailing Address - Fax:
Practice Address - Street 1:510 RICHMOND AVE APT 442
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-5582
Practice Address - Country:US
Practice Address - Phone:781-454-8499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-28
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10001611101YM0800X
TX120704225X00000X
MA13007225X00000X
TX94080101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist