Provider Demographics
NPI:1376799940
Name:JACOBSON OLIVERI, NADINE ANN (MS, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:NADINE
Middle Name:ANN
Last Name:JACOBSON OLIVERI
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 HANG DOG LN
Mailing Address - Street 2:
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-4025
Mailing Address - Country:US
Mailing Address - Phone:860-571-9349
Mailing Address - Fax:
Practice Address - Street 1:61 S MAIN ST STE 204
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-2403
Practice Address - Country:US
Practice Address - Phone:860-559-5512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-14
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist