Organization
THE OLIVE BRANCH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERA CAMPBELL (OWNER)
(910) 849-5517
Entity
Organization
Contact information
Practice address
1603 CAPITOL AVE STE 303C, CHEYENNE, WY 82001-4561
(910) 849-5517
Mailing address
1603 CAPITOL AVE STE 303C, CHEYENNE, WY 82001-4561
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
08/03/2018
Last updated
08/03/2018
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