Provider Demographics
NPI:1740769942
Name:OLIVIER, TRACI W (PSYD)
Entity type:Individual
Prefix:DR
First Name:TRACI
Middle Name:W
Last Name:OLIVIER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4611 BLUEBONNET BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-9651
Mailing Address - Country:US
Mailing Address - Phone:225-926-7500
Mailing Address - Fax:225-924-0188
Practice Address - Street 1:4611 BLUEBONNET BLVD STE B
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-9651
Practice Address - Country:US
Practice Address - Phone:225-926-7500
Practice Address - Fax:225-924-0188
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-08
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1462103T00000X, 103TC0700X, 103TC2200X, 103TH0100X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service