Provider Demographics
NPI:1730476797
Name:OLIVER, CAROLINE CONNER (MED, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:CONNER
Last Name:OLIVER
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2903 OAKHURST AVE
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78703-1951
Mailing Address - Country:US
Mailing Address - Phone:512-965-4240
Mailing Address - Fax:
Practice Address - Street 1:2903 OAKHURST AVE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78703-1951
Practice Address - Country:US
Practice Address - Phone:512-965-4240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1063140103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst