Provider Demographics
NPI:1881124683
Name:JONES, OLIVIA RAE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:RAE
Last Name:JONES
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:MS
Other - First Name:OLIVIA
Other - Middle Name:RAE
Other - Last Name:CHOATE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6390 W BUGGS RD
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53548-9343
Mailing Address - Country:US
Mailing Address - Phone:608-728-2207
Mailing Address - Fax:608-755-3856
Practice Address - Street 1:101 E MILWAUKEE ST
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53545-3056
Practice Address - Country:US
Practice Address - Phone:608-728-2207
Practice Address - Fax:608-621-3804
Is Sole Proprietor?:No
Enumeration Date:2017-06-14
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4468-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist