Provider Demographics
NPI:1801206594
Name:OLIVEIRA, KAREN (MED)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:
Last Name:OLIVEIRA
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-3505
Mailing Address - Country:US
Mailing Address - Phone:508-990-3112
Mailing Address - Fax:
Practice Address - Street 1:21 JAMES ST
Practice Address - Street 2:
Practice Address - City:FAIRHAVEN
Practice Address - State:MA
Practice Address - Zip Code:02719-3505
Practice Address - Country:US
Practice Address - Phone:508-990-3112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-02
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst