Provider Demographics
NPI:1982067930
Name:OLIVER, ERIN (MED, CRC)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:OLIVER
Suffix:
Gender:F
Credentials:MED, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 BUCKINGHAM ST
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06710-1908
Mailing Address - Country:US
Mailing Address - Phone:203-721-4774
Mailing Address - Fax:203-755-2479
Practice Address - Street 1:74 BUCKINGHAM ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06710-1908
Practice Address - Country:US
Practice Address - Phone:203-721-4774
Practice Address - Fax:203-755-2479
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-29
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health