Provider Demographics
NPI:1669094470
Name:OLIVER-CEPHAS, ALBA
Entity type:Individual
Prefix:
First Name:ALBA
Middle Name:
Last Name:OLIVER-CEPHAS
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 1:7610 CARROLL AVE SUITE 200
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912
Mailing Address - Country:US
Mailing Address - Phone:301-891-2077
Mailing Address - Fax:
Practice Address - Street 1:7610 CARROLL AVE SUITE 200
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912
Practice Address - Country:US
Practice Address - Phone:301-891-2077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-14
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health