Provider Demographics
NPI:1285451351
Name:OLIVA SERNA, LORENA
Entity type:Individual
Prefix:
First Name:LORENA
Middle Name:
Last Name:OLIVA SERNA
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 1:1216 NE 16TH PL
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32609-3843
Mailing Address - Country:US
Mailing Address - Phone:352-275-2122
Mailing Address - Fax:
Practice Address - Street 1:1216 NE 16TH PL
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32609-3843
Practice Address - Country:US
Practice Address - Phone:352-275-2122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-20
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty