Provider Demographics
NPI:1295870509
Name:WORKMAN, OLIVER (SPEECH THERAPY)
Entity type:Individual
Prefix:MR
First Name:OLIVER
Middle Name:
Last Name:WORKMAN
Suffix:
Gender:M
Credentials:SPEECH THERAPY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8721 HUNTERS CREEK DR S
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-9019
Mailing Address - Country:US
Mailing Address - Phone:904-363-3709
Mailing Address - Fax:904-363-1670
Practice Address - Street 1:8721 HUNTERS CREEK DR S
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-9019
Practice Address - Country:US
Practice Address - Phone:904-363-3709
Practice Address - Fax:904-363-1670
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA2166235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist