Individual
OLIVIA Q RICHEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
714 LINCOLNWAY, LA PORTE, IN 46350-3353
(219) 763-8112
(219) 728-1639
Mailing address
PO BOX 1430, PORTAGE, IN 46368-9230
(219) 763-8112
(219) 764-5380
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
99100409A
IN
Other
Enumeration date
12/29/2020
Last updated
12/29/2020
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