1891444972 NPI number — DANICA OLSON LIGATO-RIDING LPC

Table of content: DANICA OLSON LIGATO-RIDING LPC (NPI 1891444972)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891444972 NPI number — DANICA OLSON LIGATO-RIDING LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LIGATO-RIDING
Provider First Name:
DANICA
Provider Middle Name:
OLSON
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1891444972
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/23/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
944 JUSTIN DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WINDER
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30680-3188
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
678-551-8043
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 HUNTINGTON RD STE 101
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ATHENS
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30606-7205
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-541-8510
Provider Business Practice Location Address Fax Number:
706-504-9549
Provider Enumeration Date:
03/23/2022

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  LPC012022 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com