Provider Demographics
NPI:1689423543
Name:DOVERSPIKE, OLIVIA RAY
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:RAY
Last Name:DOVERSPIKE
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 1:509 PEACH ST APT 4
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16501-1130
Mailing Address - Country:US
Mailing Address - Phone:814-516-1064
Mailing Address - Fax:
Practice Address - Street 1:2222 FILMORE AVE STE 400
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-2984
Practice Address - Country:US
Practice Address - Phone:814-273-6270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-14
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor