Provider Demographics
NPI:1811029812
Name:OLTHAUS, SHARON ELIZABETH (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:ELIZABETH
Last Name:OLTHAUS
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 WESTBOURNE DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45248-5127
Mailing Address - Country:US
Mailing Address - Phone:513-451-1551
Mailing Address - Fax:513-451-1534
Practice Address - Street 1:3301 WESTBOURNE DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45248-5127
Practice Address - Country:US
Practice Address - Phone:513-451-1551
Practice Address - Fax:513-451-1534
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2009-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP7004235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH204206496OtherTAX ID NUMBER