Provider Demographics
NPI:1689478679
Name:OLIVIER, JAZZMYNE (PCD, CLC, NHST, CPT)
Entity type:Individual
Prefix:
First Name:JAZZMYNE
Middle Name:
Last Name:OLIVIER
Suffix:
Gender:F
Credentials:PCD, CLC, NHST, CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 MALLET HILL RD APT 3101
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-4481
Mailing Address - Country:US
Mailing Address - Phone:803-467-9438
Mailing Address - Fax:
Practice Address - Street 1:751 MALLET HILL RD APT 3101
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-4481
Practice Address - Country:US
Practice Address - Phone:803-467-9438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC235500000X
374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist