Provider Demographics
NPI:1952150898
Name:PHILLIPS, OLIVIA TAYLOR (SLP)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:TAYLOR
Last Name:PHILLIPS
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 1:128 WHISPER WAY
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-6881
Mailing Address - Country:US
Mailing Address - Phone:843-599-4586
Mailing Address - Fax:
Practice Address - Street 1:989 KNOX ABBOTT DR
Practice Address - Street 2:
Practice Address - City:CAYCE
Practice Address - State:SC
Practice Address - Zip Code:29033-3346
Practice Address - Country:US
Practice Address - Phone:803-569-8913
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-14
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist