Provider Demographics
NPI:1891418638
Name:SPINELLO, OLIVIA ANNE (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:ANNE
Last Name:SPINELLO
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:570 CALM LAKE CIR APT A
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14612-2639
Mailing Address - Country:US
Mailing Address - Phone:585-729-1224
Mailing Address - Fax:
Practice Address - Street 1:1932 KENDALL RD
Practice Address - Street 2:
Practice Address - City:KENDALL
Practice Address - State:NY
Practice Address - Zip Code:14476-9775
Practice Address - Country:US
Practice Address - Phone:585-659-2741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032249235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist