Individual
MRS. KIMBERLY OLTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
2848 PLEASANT RD STE 101, FORT MILL, SC 29708-9494
(800) 779-4089
Mailing address
2848 PLEASANT RD STE 101, FORT MILL, SC 29708-9494
(800) 779-4089
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4745
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4745
STATE LICENSE
SC
Enumeration date
07/18/2019
Last updated
07/18/2019
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