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Individual

SHAYLEE OLIVE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
6498 WAY AVE, FORT BENNING, GA 31905-3771
(706) 545-7401
Mailing address
6498 WAY AVE, FORT BENNING, GA 31905-3771
(706) 545-7401

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
247200000X
Other Technician

Other

Enumeration date
02/29/2016
Last updated
08/23/2021
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