Provider Demographics
NPI:1104556703
Name:OLIMPO, ISABELLA ASHLEY
Entity type:Individual
Prefix:
First Name:ISABELLA
Middle Name:ASHLEY
Last Name:OLIMPO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3943 DAYSTAR DR
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18902-1254
Mailing Address - Country:US
Mailing Address - Phone:215-407-4071
Mailing Address - Fax:
Practice Address - Street 1:3943 DAYSTAR DR
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18902-1254
Practice Address - Country:US
Practice Address - Phone:215-407-4071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist