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General NPI Number Information
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NPI Number | 1518217942
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Entity Type | Individual
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Provider Name | LUCIANE LOPES DE OLIVEIRA
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Gender | Female
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Dates
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Enumeration Date | 09/13/2012
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Last Update Date | 09/27/2022
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Provider Practice Location Address
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Address Line | 725 N 12TH AVE BLDG B
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City | ARCADIA
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State | FL
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Zip | 34266-8752
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Country | US
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Telephone | 863-494-1242
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Fax |
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Provider Business Mailing Address
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Address Line | 8057 SO 2700 WEST
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City | WEST JORDAN
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State | UT
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Zip | 84088
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Country | US
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Telephone | 801-352-2594
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | SW15337
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License Number State | FL
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