Healthcare Provider Details

I. General information

NPI: 1578541637
Provider Name (Legal Business Name): KAREN OLIVER PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2006
Last Update Date: 05/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOPPIN ST CORO CENTER, 3RD FLOOR
PROVIDENCE RI
02903-4141
US

IV. Provider business mailing address

PO BOX 3238
BOSTON MA
02241-3238
US

V. Phone/Fax

Practice location:
  • Phone: 401-793-8770
  • Fax:
Mailing address:
  • Phone: 866-689-8862
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS00900
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: