Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician | ||
N | 156F00000X | Technician/Technologist |
NPI | 1174197032 |
---|---|
Provider Name | Livia Deoliveira |
First Address | Ann Arbor, MI 48108-9632 |
Second Address | Ann Arbor, MI 48108-9632 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2021 |
Last Update Date | 07/06/2021 |