Individual
MALLORY LYNN OLIVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
224 HIGH ST, CUMBERLAND, RI 02864-7904
(774) 955-7483
Mailing address
224 HIGH ST, CUMBERLAND, RI 02864-7904
(774) 955-7483
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
93962
MA
Other
Enumeration date
04/09/2021
Last updated
04/09/2021
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