Provider Demographics
NPI:1770951485
Name:OLIVERI, CARMEN FRECH (SLP)
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:FRECH
Last Name:OLIVERI
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 1:616 CLEARWATER PARK RD
Mailing Address - Street 2:APT 1409
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-6226
Mailing Address - Country:US
Mailing Address - Phone:772-807-2549
Mailing Address - Fax:
Practice Address - Street 1:616 CLEARWATER PARK RD
Practice Address - Street 2:APT 1409
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-6226
Practice Address - Country:US
Practice Address - Phone:772-807-2549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-11
Last Update Date:2015-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ7288235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist