Healthcare Provider Details

I. General information

NPI: 1316854946
Provider Name (Legal Business Name): OLIVIA BOBECK MS, PSYS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13070 DURKEE RD
GRAFTON OH
44044-1122
US

IV. Provider business mailing address

13070 DURKEE RD
GRAFTON OH
44044-1122
US

V. Phone/Fax

Practice location:
  • Phone: 440-748-6869
  • Fax:
Mailing address:
  • Phone: 440-748-6869
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberLSP.03138
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: