Provider Demographics
NPI:1023243532
Name:OLIVER, GINGER LYNN (SLP)
Entity type:Individual
Prefix:
First Name:GINGER
Middle Name:LYNN
Last Name:OLIVER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:177 KRISTA COVE
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TN
Mailing Address - Zip Code:38242
Mailing Address - Country:US
Mailing Address - Phone:731-571-3095
Mailing Address - Fax:
Practice Address - Street 1:125 HOSPITAL DRIVE
Practice Address - Street 2:
Practice Address - City:MCKENZIE
Practice Address - State:TN
Practice Address - Zip Code:38201
Practice Address - Country:US
Practice Address - Phone:731-352-3908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-28
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3872235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist