The Olive Branch, LLC

NPI #1114405875 in Cheyenne, Wyoming

Provider Information

NPI Number: 1114405875
Entity Type: Organization
Organization Name: The Olive Branch, LLC
Primary Specialty: Behavior Analyst
Enumeration Date: Aug 3, 2018
Last Updated: Aug 3, 2018

Practice Location

Address: 1603 CAPITOL AVE STE 303C
City: Cheyenne
State: Wyoming
ZIP Code: 82001-4561
Phone: (910) 849-5517

Authorized Official

Name: TERA CAMPBELL
Title: OWNER
Phone: (910) 849-5517

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Analyst	103K00000X	Primary

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