Provider Demographics
NPI:1053063875
Name:OLIVER, ASHLEY (PSYD)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:OLIVER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6006 43RD AVE APT 3E
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-4992
Mailing Address - Country:US
Mailing Address - Phone:770-718-7811
Mailing Address - Fax:
Practice Address - Street 1:145 E 32ND ST FL 9
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6060
Practice Address - Country:US
Practice Address - Phone:212-535-0822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-23
Last Update Date:2022-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist