Provider Demographics
NPI:1730231325
Name:OLIVO, JUANA ELSIE (COUNSELOR)
Entity type:Individual
Prefix:
First Name:JUANA
Middle Name:ELSIE
Last Name:OLIVO
Suffix:
Gender:F
Credentials:COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:754 E 151ST ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10455-3267
Mailing Address - Country:US
Mailing Address - Phone:718-402-2800
Mailing Address - Fax:718-993-4395
Practice Address - Street 1:754 E 151ST ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10455-3267
Practice Address - Country:US
Practice Address - Phone:718-402-2800
Practice Address - Fax:718-993-4395
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor