Healthcare Provider Details

I. General information

NPI: 1285202424
Provider Name (Legal Business Name): OLIVIA CORFEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2021
Last Update Date: 06/15/2021
Certification Date: 06/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 THOMPSON RD
WEBSTER MA
01570-1509
US

IV. Provider business mailing address

340 THOMPSON RD
WEBSTER MA
01570-1509
US

V. Phone/Fax

Practice location:
  • Phone: 508-640-2957
  • Fax: 508-943-2604
Mailing address:
  • Phone: 508-640-2957
  • Fax: 508-943-2604

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: