Provider Demographics
NPI:1508215971
Name:OLARTE, GERARDO (PHD)
Entity Type:Individual
Prefix:
First Name:GERARDO
Middle Name:
Last Name:OLARTE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1146 PEBBLE CREEK XING
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-8959
Mailing Address - Country:US
Mailing Address - Phone:305-588-7488
Mailing Address - Fax:984-329-7082
Practice Address - Street 1:1146 PEBBLE CREEK XING
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-8959
Practice Address - Country:US
Practice Address - Phone:305-588-7488
Practice Address - Fax:984-329-7082
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-07
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11757235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist