Provider Demographics
NPI:1316838089
Name:WALZ, OLIVIA ROSE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:ROSE
Last Name:WALZ
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1828 WALDRON RD
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78418-4538
Mailing Address - Country:US
Mailing Address - Phone:361-792-0822
Mailing Address - Fax:361-288-4109
Practice Address - Street 1:1828 WALDRON RD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78418-4538
Practice Address - Country:US
Practice Address - Phone:361-792-0822
Practice Address - Fax:361-288-4109
Is Sole Proprietor?:No
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX122282235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist