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NPI Code Detail

MEDICARE: SHERYL L OLECK

MEDICARE: SHERYL L OLECK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianRBT-20-127371FL

General Provider Information

NPI Number : 1902414071
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHERYL L OLECK
Provider Business Mailing Address
First Line : 5400 WOOD HURST DR
Second Line :
City : PANAMA CITY
State : FL
Zip : 32404-5318
Country : US
Telephone Number : 850-630-5864
Fax Number :
Provider Business Practice Location Address
First Line : 2404 RUTH HENTZ AVE
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-2258
Country : US
Telephone Number : 850-815-8800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2020
Last Update Date : 07/15/2020

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