Doctor Name: | MRS. EVA J OLIPHANT |
NPI Number: | 1942542683 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC LICENSED PROFESS |
License Number: | 66998 |
Business Practice Address: | 817 Mlk Willis, TX - 773780817 |
Business Phone Number: | 9366614043 |
Business Fax Number: | |
Mailing Address: | P.o. Box 1051, 817 Mlk WILLIS |
State: | TX |
Postal Code: | 773781051 |
Phone Number: | 9366614043 |
Fax Number: | |
NPI Enumeration Date: | 03/20/2013 |
NPI Last Update Date: | 03/20/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 66998 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |