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General NPI Number Information
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NPI Number | 1093205494
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Entity Type | Individual
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Provider Name | OLIVIA J BISHOP
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Gender | Female
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Dates
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Enumeration Date | 05/11/2018
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Last Update Date | 05/11/2018
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Provider Practice Location Address
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Address Line | 1881 US HIGHWAY 127 N
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City | EATON
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State | OH
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Zip | 45320-9284
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Country | US
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Telephone | 513-896-3444
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Fax |
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Provider Business Mailing Address
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Address Line | 1020 SYMMES RD
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City | FAIRFIELD
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State | OH
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Zip | 45014-1844
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Country | US
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Telephone | 513-868-7654
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 165219
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License Number State | OH
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