Healthcare Provider Details

I. General information

NPI: 1336944560
Provider Name (Legal Business Name): OLIVIA TIPSWORD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2025
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

431 E BROAD ST
COLUMBUS OH
43215-4004
US

IV. Provider business mailing address

5430 OLIVIA MICHAL PL APT 206
WESTERVILLE OH
43081-6062
US

V. Phone/Fax

Practice location:
  • Phone: 614-885-5020
  • Fax:
Mailing address:
  • Phone: 419-356-3574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT013312
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: