| Doctor Name: | ANGELA OLIVA |
| NPI Number: | 1144622564 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 6802086191 |
| Business Practice Address: | 1022 E Main St Benton Harbor, MI - 490223036 |
| Business Phone Number: | 2699260015 |
| Business Fax Number: | |
| Mailing Address: | 5732 113th Ave, FENNVILLE |
| State: | MI |
| Postal Code: | 494088513 |
| Phone Number: | 2693526377 |
| Fax Number: | |
| NPI Enumeration Date: | 09/17/2014 |
| NPI Last Update Date: | 09/17/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 6802086191 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |