Provider Demographics
NPI:1952976417
Name:OLIVETO, ALEXIA
Entity type:Individual
Prefix:
First Name:ALEXIA
Middle Name:
Last Name:OLIVETO
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 1:88 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:ENTERPRISE
Mailing Address - State:WV
Mailing Address - Zip Code:26568-7523
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:88 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:ENTERPRISE
Practice Address - State:WV
Practice Address - Zip Code:26568-7523
Practice Address - Country:US
Practice Address - Phone:304-612-4735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant