Provider Demographics
NPI:1154169373
Name:HUETT, OLIVIA JOSEPHINE
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:JOSEPHINE
Last Name:HUETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1665 DOE TRL
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-6096
Mailing Address - Country:US
Mailing Address - Phone:501-733-5946
Mailing Address - Fax:
Practice Address - Street 1:405 EDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:MAUMELLE
Practice Address - State:AR
Practice Address - Zip Code:72113-6267
Practice Address - Country:US
Practice Address - Phone:501-803-9722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-20
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist