Provider Demographics
NPI:1366016545
Name:OVIE, BLESSED
Entity Type:Individual
Prefix:
First Name:BLESSED
Middle Name:
Last Name:OVIE
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 1:210 CHARLES ST APT 304
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453-4257
Mailing Address - Country:US
Mailing Address - Phone:857-423-9231
Mailing Address - Fax:
Practice Address - Street 1:210 CHARLES ST APT 304
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02453-4257
Practice Address - Country:US
Practice Address - Phone:857-423-9231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-13
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator