Individual
JANET S OLIVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
09 LLANO VISTA RD, BLACK LAKE DIVISION, ANGEL FIRE, NM 87710
(505) 377-3193
Mailing address
P.O. BOX 1319, ANGEL FIRE, NM 87710
(505) 377-3193
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
91521
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42980844
—
NM
Enumeration date
09/07/2006
Last updated
07/09/2007
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