Healthcare Provider Details

I. General information

NPI: 1164633897
Provider Name (Legal Business Name): MICHELLE L. OLIVER MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELLE OLIVER MS, CCC-SLP

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1340 S WALDRON RD
FORT SMITH AR
72903-2556
US

IV. Provider business mailing address

1500 HOUSTON ST
FORT SMITH AR
72901-7214
US

V. Phone/Fax

Practice location:
  • Phone: 479-755-6601
  • Fax:
Mailing address:
  • Phone: 479-414-9450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP#2512
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: