Provider Demographics
NPI:1548084544
Name:OLAYA, CAMILA
Entity type:Individual
Prefix:
First Name:CAMILA
Middle Name:
Last Name:OLAYA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4448 W GUNNISON ST APT 2A
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630-2539
Mailing Address - Country:US
Mailing Address - Phone:561-506-9285
Mailing Address - Fax:
Practice Address - Street 1:4448 W GUNNISON ST APT 2A
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630-2539
Practice Address - Country:US
Practice Address - Phone:561-506-9285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-14
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker