Individual
MRS. JACQUELIN DENETTE OLIVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MHPP
Contact information
Practice address
229 A ST, MAGNOLIA, AR 71753-3653
(870) 234-9029
(870) 234-7740
Mailing address
229 A ST, MAGNOLIA, AR 71753-3653
(870) 234-9029
(870) 234-7740
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
MENTAL HEALTH PARAPROFESSIONAL
AR
Enumeration date
12/29/2008
Last updated
12/29/2008
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