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General NPI Number Information
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NPI Number | 1821667650
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Entity Type | Individual
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Provider Name | AYANNA AHSHA OLIVER
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Gender | Female
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Dates
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Enumeration Date | 06/24/2021
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Last Update Date | 05/10/2024
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Provider Practice Location Address
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Address Line | 978 NEW YORK 45 SUITE 100
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City | POMONA
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State | NY
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Zip | 10970
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Country | US
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Telephone | 845-535-4142
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Fax |
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Provider Business Mailing Address
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Address Line | 1741 LEXINGTON AVE APT 5
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City | NEW YORK
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State | NY
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Zip | 10029-3511
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Country | US
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Telephone | 929-422-9333
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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