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Individual

OLIVIA MARIE WILLISHENRY

Active
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Individual

OLIVIA MARIE WILLISHENRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA CCC SLP, MA CCC-A

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
AU874
CA
235Z00000X
Speech-Language Pathologist
Primary
SP5477
CA
235Z00000X
Speech-Language Pathologist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
SP5477
SPEECH PATHOLOGY LICENSE NUMBER
CA
Enumeration date
09/21/2009
Last updated
12/24/2023
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