Provider Demographics
NPI:1629368683
Name:OLIVER-CEBOLLERO, WILMA E (MS,CFY,SLP)
Entity Type:Individual
Prefix:
First Name:WILMA
Middle Name:E
Last Name:OLIVER-CEBOLLERO
Suffix:
Gender:F
Credentials:MS,CFY,SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 SE 18TH AVE
Mailing Address - Street 2:DEERWOOD VILLAGE APARTMENTS APT.3304
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-8240
Mailing Address - Country:US
Mailing Address - Phone:787-922-6548
Mailing Address - Fax:
Practice Address - Street 1:1850 18TH SE AVE.
Practice Address - Street 2:APT.3304 DEERWOOD VILLAGE APARTMENTS
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471
Practice Address - Country:US
Practice Address - Phone:787-922-6548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-12
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ5345235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist