Provider Demographics
NPI:1780179994
Name:STIPANOVICH, OLIVIA (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:STIPANOVICH
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:OLIVIA
Other - Middle Name:
Other - Last Name:CATT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:106 JOHN ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-1653
Mailing Address - Country:US
Mailing Address - Phone:803-521-9446
Mailing Address - Fax:
Practice Address - Street 1:106 JOHN ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-1653
Practice Address - Country:US
Practice Address - Phone:803-521-9446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-29
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist