Healthcare Provider Details

I. General information

NPI: 1871960914
Provider Name (Legal Business Name): OLGA SHVETS MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2015
Last Update Date: 08/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 WHITE HORSE PIKE UNIT 1C
WEST COLLINGSWOOD NJ
08107-1763
US

IV. Provider business mailing address

505 WHITE HORSE PIKE UNIT 1C
WEST COLLINGSWOOD NJ
08107-1763
US

V. Phone/Fax

Practice location:
  • Phone: 201-805-5584
  • Fax:
Mailing address:
  • Phone: 201-805-5584
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number41YS00708200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: