Provider Demographics
NPI:1881620953
Name:OLOPAI, PATRICE T (MA, CCC-A)
Entity type:Individual
Prefix:
First Name:PATRICE
Middle Name:T
Last Name:OLOPAI
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:PATRICE
Other - Middle Name:M
Other - Last Name:TOURNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:P.O. BOX 406153
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-1876
Mailing Address - Country:US
Mailing Address - Phone:954-963-6305
Mailing Address - Fax:
Practice Address - Street 1:3251 HOLLYWOOD BLVD
Practice Address - Street 2:STE 424
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021
Practice Address - Country:US
Practice Address - Phone:954-963-6305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1097231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4899821OtherGHI
FL600339700Medicaid
FLS2298ZMedicare PIN