Individual
TASHA OLIVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
101 PHOENIX AVE, SUITE 2D, ENFIELD, CT 06082-4471
(860) 741-2541
(860) 745-5264
Mailing address
101 PHOENIX AVE, SUITE 2D, ENFIELD, CT 06082-4471
(860) 741-2541
(860) 745-5264
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
010789
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010789
STATE LICENSE
CT
Enumeration date
04/12/2016
Last updated
04/12/2016
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