Provider Demographics
NPI:1265135255
Name:BOBB, OLIVIA N
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:N
Last Name:BOBB
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 1:66 S DOUGLASS ST APT 402
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-1376
Mailing Address - Country:US
Mailing Address - Phone:740-891-0101
Mailing Address - Fax:
Practice Address - Street 1:66 S DOUGLASS ST APT 402
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-1376
Practice Address - Country:US
Practice Address - Phone:740-891-0101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist