Provider Demographics
NPI:1215624408
Name:OLIVER, MARIAMA
Entity type:Individual
Prefix:
First Name:MARIAMA
Middle Name:
Last Name:OLIVER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2543 MERIDIAN PKWY APT 4209
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-4222
Mailing Address - Country:US
Mailing Address - Phone:251-533-1523
Mailing Address - Fax:
Practice Address - Street 1:2543 MERIDIAN PKWY APT 4209
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-4222
Practice Address - Country:US
Practice Address - Phone:251-533-1523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-19
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician