Individual
JASON JOHN OLVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3300 36TH ST SE, GRAND RAPIDS, MI 49512-2810
(616) 942-2110
Mailing address
3300 36TH ST SE, GRAND RAPIDS, MI 49512-2810
(616) 942-2110
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2-01811
MI
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
06/28/2018
Last updated
11/27/2023
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