Provider Demographics
NPI:1336812981
Name:SCOBIE, OLIVIA R (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:R
Last Name:SCOBIE
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 1:113 ADAMS AVE UNIT 113
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-4304
Mailing Address - Country:US
Mailing Address - Phone:203-415-0889
Mailing Address - Fax:
Practice Address - Street 1:100 CUMMINGS CTR STE 135C
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-6263
Practice Address - Country:US
Practice Address - Phone:978-473-7300
Practice Address - Fax:978-969-0083
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-29
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA42569235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist