# OLIVE BRANCH PSYCHIATRY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Oliva Branch Clinic, Olive Branch Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528512183
- **Authorized official:** WILLIAM OLIVA MD (CHIEF MEDICAL OFFICER)
- **Authorized official phone:** (405) 451-3454

## Contact information

- **Practice address:** 13821 TECHNOLOGY DR STE B, OKLAHOMA CITY, OK 73134-1046
- **Practice address phone:** (405) 451-3454
- **Practice address fax:** (405) 451-3454
- **Mailing address:** 13821 TECHNOLOGY DR STE B, OKLAHOMA CITY, OK 73134-1046
- **Mailing address phone:** (405) 451-3454
- **Mailing address fax:** (405) 543-7359

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | NULL | Yes |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/11/2016
- **Last updated:** 10/04/2022