Healthcare Provider Details

I. General information

NPI: 1922925288
Provider Name (Legal Business Name): MRS. CHRISTINE OLIVER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12301 SIERRA GRANDE AVE NE
ALBUQUERQUE NM
87112-5838
US

IV. Provider business mailing address

12301 SIERRA GRANDE AVE NE
ALBUQUERQUE NM
87112-5838
US

V. Phone/Fax

Practice location:
  • Phone: 505-228-5736
  • Fax:
Mailing address:
  • Phone: 505-228-5736
  • 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: