MEDICARE: OLIVIA FRICK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1982443248
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLIVIA FRICK

Provider Business Mailing Address
First Line	:	457 TAFT AVE
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52245-7609
Country	:	US
Telephone Number	:	563-508-8906
Fax Number	:

Provider Business Practice Location Address
First Line	:	2545 N DODGE ST STE A
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52245-9558
Country	:	US
Telephone Number	:	920-857-9041
Fax Number	:	920-857-3366

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2024
Last Update Date	:	05/24/2024

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Directions to “ OLIVIA FRICK ” Practice Location

Language	Start Address	Practice Location

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