Provider Demographics
NPI:1275041394
Name:OLIVERA SANCHEZ, AIMEE KATHLEEN (MSW)
Entity Type:Individual
Prefix:MS
First Name:AIMEE
Middle Name:KATHLEEN
Last Name:OLIVERA SANCHEZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 COLONEL WAY
Mailing Address - Street 2:
Mailing Address - City:ODENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21113-1029
Mailing Address - Country:US
Mailing Address - Phone:910-988-5760
Mailing Address - Fax:
Practice Address - Street 1:2150 COLONEL WAY
Practice Address - Street 2:
Practice Address - City:ODENTON
Practice Address - State:MD
Practice Address - Zip Code:21113
Practice Address - Country:US
Practice Address - Phone:910-988-5760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-11
Last Update Date:2018-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI43111041C0700X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker