Provider Demographics
NPI:1346999661
Name:OLIVEIRA, MARIA REGINA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:REGINA
Last Name:OLIVEIRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:488 UPPER COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:DENNIS PORT
Mailing Address - State:MA
Mailing Address - Zip Code:02639-1402
Mailing Address - Country:US
Mailing Address - Phone:508-221-8144
Mailing Address - Fax:
Practice Address - Street 1:436 STATION AVE UNIT B
Practice Address - Street 2:
Practice Address - City:SOUTH YARMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02664-1208
Practice Address - Country:US
Practice Address - Phone:508-694-0101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-23
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAS77780132103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst