Individual
MR. KEVIN PAUL OLIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, MPA, LCAS
Contact information
Practice address
2505 COURT DR, GASTONIA, NC 28054-2140
(704) 921-3070
Mailing address
4007 WILD NURSERY CT, CHARLOTTE, NC 28215-5345
(704) 921-3070
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1035
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6111882
—
NC
Enumeration date
12/19/2006
Last updated
08/30/2007
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