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General NPI Number Information
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NPI Number | 1346948866
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Entity Type | Individual
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Provider Name | WALTER DANIEL OLIVER
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Gender | Male
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Dates
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Enumeration Date | 02/23/2023
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Last Update Date | 05/27/2024
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Provider Practice Location Address
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Address Line | 13466 NEVILLE DR
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City | SPRING HILL
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State | FL
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Zip | 34609-8837
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Country | US
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Telephone | 706-847-7043
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Fax |
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Provider Business Mailing Address
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Address Line | 13466 NEVILLE DR
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City | SPRING HILL
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State | FL
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Zip | 34609-8837
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Country | US
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Telephone | 706-847-7043
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | 0-24-15231
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-19-98514
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License Number State | GA
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