MEDICARE: TANYA MARIE OLIVEIRA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1982299723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TANYA MARIE OLIVEIRA

Provider Business Mailing Address
First Line	:	3 ELLWOOD PL APT 2
Second Line	:
City	:	NEWPORT
State	:	RI
Zip	:	02840-2275
Country	:	US
Telephone Number	:	404-489-4982
Fax Number	:

Provider Business Practice Location Address
First Line	:	67 VALLEY RD
Second Line	:
City	:	MIDDLETOWN
State	:	RI
Zip	:	02842-7274
Country	:	US
Telephone Number	:	401-489-4982
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2021
Last Update Date	:	02/14/2022

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Directions to “ TANYA MARIE OLIVEIRA ” Practice Location

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