MEDICARE: MRS. SHARON ELIZABETH OLTHAUS MS CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SP7004	OH

General Provider Information

NPI Number	:	1811029812
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHARON ELIZABETH OLTHAUS MS CCC-SLP

Provider Business Mailing Address
First Line	:	3301 WESTBOURNE DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45248-5127
Country	:	US
Telephone Number	:	513-451-1551
Fax Number	:	513-451-1534

Provider Business Practice Location Address
First Line	:	3301 WESTBOURNE DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45248-5127
Country	:	US
Telephone Number	:	513-451-1551
Fax Number	:	513-451-1534

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	05/25/2009

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