Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 097249-1 | NY |
NPI | 1003348467 |
---|---|
Provider Name | Miss Glendalee L Olivera |
First Address | Bronxville, NY 10708-6160 |
Second Address | Bronxville, NY 10708-6160 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2017 |
Last Update Date | 03/04/2017 |