Individual
KRISTA KAY OLIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
926 S WASHINGTON AVE, HOLLAND, MI 49423-7725
(616) 820-3780
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 455-5000
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
6301010515
MI
103TC0700X
Clinical Psychologist
Primary
6301010505
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P108951000
BC/BS
MI
Enumeration date
06/09/2006
Last updated
11/21/2022
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