Provider Demographics
NPI:1235541707
Name:OLBRYCH, DAVID
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:OLBRYCH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MASHPEE
Mailing Address - State:MA
Mailing Address - Zip Code:02649-2047
Mailing Address - Country:US
Mailing Address - Phone:508-760-1475
Mailing Address - Fax:
Practice Address - Street 1:470 MAIN ST
Practice Address - Street 2:
Practice Address - City:MASHPEE
Practice Address - State:MA
Practice Address - Zip Code:02649-2047
Practice Address - Country:US
Practice Address - Phone:508-760-1475
Practice Address - Fax:508-760-3719
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-02
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor