Provider Demographics
NPI:1457972259
Name:SANTANGELO, OLIVIA (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:OLIVIA
Middle Name:
Last Name:SANTANGELO
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 1:1907 1ST AVE APT 43
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1031
Mailing Address - Country:US
Mailing Address - Phone:908-547-7725
Mailing Address - Fax:
Practice Address - Street 1:12505 GREENWOOD AVE N APT 43
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-8040
Practice Address - Country:US
Practice Address - Phone:814-812-9083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-03
Last Update Date:2020-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61036206235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist