Healthcare Provider Details

I. General information

NPI: 1437860350
Provider Name (Legal Business Name): BIANCA FLORES DE OLIVEIRA COUNSELING INTERN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2022
Last Update Date: 12/12/2022
Certification Date: 12/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 HOPE AVE
WORCESTER MA
01603-2212
US

IV. Provider business mailing address

16 KRUSE RD
HUBBARDSTON MA
01452-1324
US

V. Phone/Fax

Practice location:
  • Phone: 508-755-2340
  • Fax:
Mailing address:
  • Phone: 617-501-6805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: