Provider Demographics
NPI:1992184980
Name:OLIVER, ANNA E
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:E
Last Name:OLIVER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9284 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:NY
Mailing Address - Zip Code:13135-2512
Mailing Address - Country:US
Mailing Address - Phone:315-657-7193
Mailing Address - Fax:
Practice Address - Street 1:9284 RIVER RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:NY
Practice Address - Zip Code:13135-2512
Practice Address - Country:US
Practice Address - Phone:315-657-7193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-22
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist