Provider Demographics
NPI:1790251908
Name:OLIVAS, ANAHI ANGELICA (RBT)
Entity Type:Individual
Prefix:
First Name:ANAHI
Middle Name:ANGELICA
Last Name:OLIVAS
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1808 JENICE CT
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-2048
Mailing Address - Country:US
Mailing Address - Phone:575-650-1068
Mailing Address - Fax:
Practice Address - Street 1:1808 JENICE CT
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-2048
Practice Address - Country:US
Practice Address - Phone:575-650-1068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-16
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician