Provider Demographics
NPI:1194192351
Name:WALKER, OLIVIA MAY (SLP)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:MAY
Last Name:WALKER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2036 K RD
Mailing Address - Street 2:
Mailing Address - City:WEST POINT
Mailing Address - State:NE
Mailing Address - Zip Code:68788-3532
Mailing Address - Country:US
Mailing Address - Phone:712-202-8838
Mailing Address - Fax:
Practice Address - Street 1:2036 K RD
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:NE
Practice Address - Zip Code:68788-3532
Practice Address - Country:US
Practice Address - Phone:712-202-8838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-24
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE235Z00000X
NE1807235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE476002672-68Medicaid