Provider Demographics
NPI:1750571477
Name:OLEAN, ELIZABETH J
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:J
Last Name:OLEAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 SOAP HOUSE LN
Mailing Address - Street 2:
Mailing Address - City:HOPE VALLEY
Mailing Address - State:RI
Mailing Address - Zip Code:02832
Mailing Address - Country:US
Mailing Address - Phone:401-539-2605
Mailing Address - Fax:
Practice Address - Street 1:111 PEIRCE ST
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-3814
Practice Address - Country:US
Practice Address - Phone:401-885-3300
Practice Address - Fax:401-886-9203
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-30
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI00068235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist