Provider Demographics
NPI:1922759745
Name:RUFFIN, OLIVIA
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:RUFFIN
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 1:499 BATH ROAD
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:PA
Mailing Address - Zip Code:19007
Mailing Address - Country:US
Mailing Address - Phone:215-458-4236
Mailing Address - Fax:
Practice Address - Street 1:306 EXTON CMNS
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2450
Practice Address - Country:US
Practice Address - Phone:610-968-1236
Practice Address - Fax:610-968-1236
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-13
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional