Individual
MS. MARY ELIZABETH OLIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
303 N HURSTBOURNE PKWY STE 200, LOUISVILLE, KY 40222-5158
(502) 412-5847
Mailing address
12350 WINDWARD DR, GULFPORT, MS 39503-5509
(228) 731-0396
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
TA1184
MS
Other
Enumeration date
09/10/2012
Last updated
09/10/2012
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