MEDICARE: OLIVIA MAKATURA

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
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1831927821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLIVIA MAKATURA

Provider Business Mailing Address
First Line	:	2785 CASON ST # 2
Second Line	:
City	:	LAFAYETTE
State	:	IN
Zip	:	47904-2843
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 WALL ST
Second Line	:
City	:	VALPARAISO
State	:	IN
Zip	:	46383-2537
Country	:	US
Telephone Number	:	317-960-4052
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2024
Last Update Date	:	07/23/2024

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Directions to “ OLIVIA MAKATURA ” Practice Location

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