Individual
MRS. MARY ELLEN OLIVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
13 PARK LAWN DR, BETHEL, CT 06801-1043
(203) 830-4180
Mailing address
57 LONGVIEW RD, MONROE, CT 06468-1702
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1740382803
CT
Other
Enumeration date
10/23/2012
Last updated
10/23/2012
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