Individual
CHANCE OLIVAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5574 MAIN ST, WILLIAMSVILLE, NY 14221-5452
(631) 316-9122
Mailing address
312 S 4TH ST UPPR, OLEAN, NY 14760-3517
(631) 316-9122
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
014856-01
NY
Other
Enumeration date
08/09/2024
Last updated
08/09/2024
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