Healthcare Provider Details

I. General information

NPI: 1598535387
Provider Name (Legal Business Name): OLIVIA DELAMORA M.S., CF-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2024
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4789 E TRAILWOOD WAY
SPRINGFIELD MO
65809-4319
US

IV. Provider business mailing address

1601 E HAYLOFT DR
OZARK MO
65721-5380
US

V. Phone/Fax

Practice location:
  • Phone: 417-725-5774
  • Fax:
Mailing address:
  • Phone: 660-322-1772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2025036630
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: