Provider Demographics
NPI:1487211660
Name:OLENA, CARRIE R (HIS)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:R
Last Name:OLENA
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:565 HEMLOCK LN
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-9066
Mailing Address - Country:US
Mailing Address - Phone:717-413-5952
Mailing Address - Fax:
Practice Address - Street 1:1004A LITITZ PIKE
Practice Address - Street 2:
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-9328
Practice Address - Country:US
Practice Address - Phone:717-625-1004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-23
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAF03762237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist