Healthcare Provider Details

I. General information

NPI: 1487574448
Provider Name (Legal Business Name): BRENDA OLENICK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

712 REDWOOD DR
CANAL FULTON OH
44614-9332
US

IV. Provider business mailing address

712 REDWOOD DR
CANAL FULTON OH
44614-9332
US

V. Phone/Fax

Practice location:
  • Phone: 330-495-6730
  • Fax:
Mailing address:
  • Phone: 330-495-6730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: