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NPI Code Detail

MEDICARE: SUZANNE OLVERA

MEDICARE: SUZANNE OLVERA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianMI

General Provider Information

NPI Number : 1073095220
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUZANNE OLVERA
Provider Business Mailing Address
First Line : 21600 OXNARD ST
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91367-4976
Country : US
Telephone Number : 818-345-2345
Fax Number :
Provider Business Practice Location Address
First Line : 100 E MAIN ST STE A
Second Line :
City : STANTON
State : MI
Zip : 48888-8601
Country : US
Telephone Number : 989-372-9550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2018
Last Update Date : 09/04/2018

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Directions to “ SUZANNE OLVERA ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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