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Individual
LORENA A OLIVERA
Active
Individual
LORENA A OLIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LAC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
33AC00117000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0023701
AGENCY MEDICAID #
NJ
01
—
7794703
MEDICAID PROIVIDER #
NJ
Enumeration date
05/25/2010
Last updated
09/09/2013
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