Individual
LISA DIANNE OLIVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13 OFFICE PARK CIR STE 19, MOUNTAIN BRK, AL 35223-2921
(205) 601-9165
Mailing address
13 OFFICE PARK CIR STE 19, MOUNTAIN BRK, AL 35223-2921
(205) 601-9165
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C3075A
AL
Other
Enumeration date
12/02/2018
Last updated
12/02/2018
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