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General NPI Number Information
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NPI Number | 1477946598
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Entity Type | Individual
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Provider Name | KIMBERLY DAWN OLIVER B.S.W, M.S.W.
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Gender | Female
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Dates
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Enumeration Date | 03/13/2015
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Last Update Date | 03/13/2015
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Provider Practice Location Address
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Address Line | 4475 S HOPKINS AVE
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City | TITUSVILLE
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State | FL
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Zip | 32780-6661
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Country | US
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Telephone | 321-269-6555
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Fax | 321-268-5347
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Provider Business Mailing Address
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Address Line | 4475 S HOPKINS AVE
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City | TITUSVILLE
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State | FL
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Zip | 32780-6661
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Country | US
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Telephone | 321-269-6555
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Fax | 321-268-5347
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | ISW9475
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License Number State | FL
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