Healthcare Provider Details

I. General information

NPI: 1285540013
Provider Name (Legal Business Name): OLIVIA FORDYCE M.S. CF-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LIV FORDYCE M.S. CF-SLP

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 E MAIN ST
NORWALK OH
44857-1714
US

IV. Provider business mailing address

80 E MAIN ST
NORWALK OH
44857-1714
US

V. Phone/Fax

Practice location:
  • Phone: 419-660-1957
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberCOND.20263425-SP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: