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General NPI Number Information
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NPI Number | 1669169009
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Entity Type | Individual
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Provider Name | OLIVIA LYNN POHOLIK
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Gender | Female
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Dates
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Enumeration Date | 04/18/2023
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Last Update Date | 04/18/2023
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Provider Practice Location Address
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Address Line | 629 PAWNEE ST
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City | LEAVENWORTH
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State | KS
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Zip | 66048-1447
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Country | US
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Telephone | 785-256-9096
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Fax |
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Provider Business Mailing Address
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Address Line | 6323 N ROBINHOOD LN
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City | KANSAS CITY
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State | MO
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Zip | 64151-2851
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Country | US
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Telephone | 773-474-8893
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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