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General NPI Number Information
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NPI Number | 1265708283
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Entity Type | Organization
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Legal Business Name | JO ANNE NOWICK OLIVER, PA
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Dates
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Enumeration Date | 03/23/2012
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Last Update Date | 04/05/2012
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Provider Practice Location Address
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Address Line | 207 W HICKORY ST SUITE 114
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City | DENTON
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State | TX
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Zip | 76201-4156
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Country | US
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Telephone | 940-891-4330
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Fax | 940-891-4330
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Provider Business Mailing Address
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Address Line | 207 W HICKORY ST SUITE 114
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City | DENTON
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State | TX
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Zip | 76201-4156
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Country | US
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Telephone | 940-891-4330
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Fax | 940-891-4330
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MR. COLE DALTON
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Credential |
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Telephone | 940-891-4330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 00865
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License Number State | TX
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