Provider Demographics
NPI:1225500317
Name:OLIVA -JOVANOVIC, SANDRA (BCBA)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:OLIVA -JOVANOVIC
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-3119
Mailing Address - Country:US
Mailing Address - Phone:551-655-7242
Mailing Address - Fax:
Practice Address - Street 1:1325 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-3119
Practice Address - Country:US
Practice Address - Phone:551-655-7242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-30
Last Update Date:2018-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst