Provider Demographics
NPI:1417350646
Name:OLIVERA, SHERRI
Entity type:Individual
Prefix:
First Name:SHERRI
Middle Name:
Last Name:OLIVERA
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 1:309 N TEMPLE ST
Mailing Address - Street 2:
Mailing Address - City:CORDELL
Mailing Address - State:OK
Mailing Address - Zip Code:73632-4233
Mailing Address - Country:US
Mailing Address - Phone:580-302-3633
Mailing Address - Fax:
Practice Address - Street 1:1121 S DOUGLAS BLVD
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73130-5210
Practice Address - Country:US
Practice Address - Phone:855-782-7822
Practice Address - Fax:855-782-7822
Is Sole Proprietor?:No
Enumeration Date:2014-10-02
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician