Individual
OLIVIA SEPRISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
190 MATCH FACTORY PL, BELLEFONTE, PA 16823-1367
(814) 353-1487
Mailing address
190 MATCH FACTORY PL, BELLEFONTE, PA 16823-1367
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235352634
—
PA
Enumeration date
01/23/2015
Last updated
01/23/2015
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