Individual
TIFFANY OLIVAREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LMHC, MCAP
Contact information
Practice address
2198 HARRIS AVE NE, PALM BAY, FL 32905-4002
(321) 951-9750
Mailing address
2198 HARRIS AVE NE, PALM BAY, FL 32905-4002
(321) 951-9750
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
MH13193
FL
251S00000X
Community/Behavioral Health Agency
MH13193
FL
Other
Enumeration date
11/23/2015
Last updated
11/23/2015
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