Healthcare Provider Details

I. General information

NPI: 1871423152
Provider Name (Legal Business Name): OLIVIA KATE WALTERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

457 MCLAWS CIR STE A
WILLIAMSBURG VA
23185-5892
US

IV. Provider business mailing address

44 SHIRLEY RD
NEWPORT NEWS VA
23601-3933
US

V. Phone/Fax

Practice location:
  • Phone: 757-271-4447
  • Fax: 847-886-4172
Mailing address:
  • Phone: 920-851-8716
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: