Healthcare Provider Details

I. General information

NPI: 1730786500
Provider Name (Legal Business Name): OLIVIA ADAME
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2020
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7551 BERWICK DR
WESTLAND MI
48185-1414
US

IV. Provider business mailing address

7551 BERWICK DR
WESTLAND MI
48185-1414
US

V. Phone/Fax

Practice location:
  • Phone: 734-441-0546
  • Fax:
Mailing address:
  • Phone: 734-441-0546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number7401003217
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number7402000195
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code156F00000X
TaxonomyTechnician/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: