Provider Demographics
NPI:1689031601
Name:SWEETMAN, OLIVIA
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:SWEETMAN
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 1:2900 W GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13219-1452
Mailing Address - Country:US
Mailing Address - Phone:518-588-8972
Mailing Address - Fax:
Practice Address - Street 1:6624 SOUTH ST
Practice Address - Street 2:
Practice Address - City:RED CREEK
Practice Address - State:NY
Practice Address - Zip Code:13143-9510
Practice Address - Country:US
Practice Address - Phone:315-754-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-21
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist