Provider Demographics
NPI:1487829040
Name:OLIVEROS, ALIZA FLORES (LBSW, LPC)
Entity Type:Individual
Prefix:MS
First Name:ALIZA
Middle Name:FLORES
Last Name:OLIVEROS
Suffix:
Gender:F
Credentials:LBSW, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 IDAHO ST
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-3212
Mailing Address - Country:US
Mailing Address - Phone:956-725-7545
Mailing Address - Fax:
Practice Address - Street 1:217 IDAHO ST
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-3212
Practice Address - Country:US
Practice Address - Phone:956-725-7545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17753101YP2500X
TXS22568104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No104100000XBehavioral Health & Social Service ProvidersSocial Worker