Provider Demographics
NPI:1225567373
Name:OLIN, JENIFER DIAMOND (BACHELORS)
Entity Type:Individual
Prefix:
First Name:JENIFER
Middle Name:DIAMOND
Last Name:OLIN
Suffix:
Gender:F
Credentials:BACHELORS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 VICTORIA ST APT 1705
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1436
Mailing Address - Country:US
Mailing Address - Phone:516-278-5666
Mailing Address - Fax:
Practice Address - Street 1:500 ALA MOANA BLVD STE 7400
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-4902
Practice Address - Country:US
Practice Address - Phone:855-832-6727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-11
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst