Individual
OLIVIA COULTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2111 S 67TH ST STE 352, OMAHA, NE 68106-2882
(531) 365-0385
Mailing address
21600 OXNARD ST STE 1800, WOODLAND HILLS, CA 91367-7807
(818) 345-2345
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
H13697426
NE
Other
Enumeration date
02/19/2019
Last updated
02/19/2019
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