Provider Demographics
NPI:1821342585
Name:SUTTON, OLGA LYNNE (MS SPED)
Entity Type:Individual
Prefix:MRS
First Name:OLGA
Middle Name:LYNNE
Last Name:SUTTON
Suffix:
Gender:F
Credentials:MS SPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1651 CONEY ISLAND AVE.
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230
Mailing Address - Country:US
Mailing Address - Phone:718-998-1415
Mailing Address - Fax:718-627-1855
Practice Address - Street 1:1651 CONEY ISLAND AVE.
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230
Practice Address - Country:US
Practice Address - Phone:718-998-1415
Practice Address - Fax:718-627-1855
Is Sole Proprietor?:No
Enumeration Date:2012-11-02
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2180155235500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist