Provider Demographics
NPI:1275992273
Name:IVEY, OLIVIA DENISE JAMISON (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:OLIVIA
Middle Name:DENISE JAMISON
Last Name:IVEY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 E AUGUSTA PL
Mailing Address - Street 2:201
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-1755
Mailing Address - Country:US
Mailing Address - Phone:864-991-8378
Mailing Address - Fax:
Practice Address - Street 1:11 E AUGUSTA PL
Practice Address - Street 2:201
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-1755
Practice Address - Country:US
Practice Address - Phone:864-991-8378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-18
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4670225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist