Provider Demographics
NPI:1649705997
Name:SOLLITTO, OLIVIA R (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:R
Last Name:SOLLITTO
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 1:62 ALFRED ST
Mailing Address - Street 2:FL 3
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06605-2967
Mailing Address - Country:US
Mailing Address - Phone:203-521-7408
Mailing Address - Fax:
Practice Address - Street 1:1300 POST RD
Practice Address - Street 2:SUITE 204
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-6038
Practice Address - Country:US
Practice Address - Phone:203-255-1173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-25
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT005042235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist