Doctor Name: | S ROLAND OLIVER |
NPI Number: | 1740221340 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | 128688-3501 |
Business Practice Address: | 4250 W 5415 S Fl 3 Kearns, UT - 841184303 |
Business Phone Number: | 8019694181 |
Business Fax Number: | |
Mailing Address: | 2317 Bonanza Cir, SOUTH JORDAN |
State: | UT |
Postal Code: | 840953103 |
Phone Number: | 8012540220 |
Fax Number: | |
NPI Enumeration Date: | 06/08/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 128688-3501 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |