Provider Demographics
NPI:1659159275
Name:UTTARO, OLIVIA ELIZABETH (SLP-CF)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:ELIZABETH
Last Name:UTTARO
Suffix:
Gender:F
Credentials:SLP-CF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 WESTCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14609-4328
Mailing Address - Country:US
Mailing Address - Phone:585-957-8987
Mailing Address - Fax:
Practice Address - Street 1:1000 ELMWOOD AVE STE 400
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-3092
Practice Address - Country:US
Practice Address - Phone:585-271-0608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-15
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist