Provider Demographics
NPI:1366683450
Name:OLIVER, PATRICIA (EDD; BCBA-D)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:
Last Name:OLIVER
Suffix:
Gender:F
Credentials:EDD; BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4878
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:CO
Mailing Address - Zip Code:80443-4878
Mailing Address - Country:US
Mailing Address - Phone:303-503-0364
Mailing Address - Fax:
Practice Address - Street 1:153 CR 926
Practice Address - Street 2:
Practice Address - City:BRECKENRIDGE
Practice Address - State:CO
Practice Address - Zip Code:80424-4878
Practice Address - Country:US
Practice Address - Phone:303-503-0364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-18
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-03-1198103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst