Doctor Name: | JAIMIE OLIVER |
NPI Number: | 1144674375 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMHC |
License Number: | 007173 |
Business Practice Address: | 303 Merrick Rd Suite 302 Lynbrook, NY - 115632501 |
Business Phone Number: | 5165543592 |
Business Fax Number: | |
Mailing Address: | 303 Merrick Rd, LYNBROOK |
State: | NY |
Postal Code: | 115632501 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 04/13/2016 |
NPI Last Update Date: | 05/31/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 007173 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |