Provider Demographics
NPI:1972662344
Name:OLIVER, KALEY FREEMAN (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KALEY
Middle Name:FREEMAN
Last Name:OLIVER
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 1:1815 EDWARDIAN WAY
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36207-6847
Mailing Address - Country:US
Mailing Address - Phone:256-835-2695
Mailing Address - Fax:
Practice Address - Street 1:409 E 10TH ST
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-4780
Practice Address - Country:US
Practice Address - Phone:256-238-0110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1880235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1880OtherSPEECH THERAPY LICENSE