Provider Demographics
NPI:1679180871
Name:LAGUERRE, OLIVIA (LMSW)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:LAGUERRE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18336 STREAMSIDE DR APT 102
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20879-5235
Mailing Address - Country:US
Mailing Address - Phone:240-527-9480
Mailing Address - Fax:
Practice Address - Street 1:18336 STREAMSIDE DR APT 102
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20879-5235
Practice Address - Country:US
Practice Address - Phone:240-527-9480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-30
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD23533104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker