Provider Demographics
NPI:1629754007
Name:HEMILTON, OLIVIA MERCEDES
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:MERCEDES
Last Name:HEMILTON
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 1:2327 SHIRECREST COVE WAY
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33558-4911
Mailing Address - Country:US
Mailing Address - Phone:727-271-6032
Mailing Address - Fax:
Practice Address - Street 1:1726 DAVENPORT DR
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655-4228
Practice Address - Country:US
Practice Address - Phone:727-493-2393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-22
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI63702355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant