Provider Demographics
NPI:1871278168
Name:GATELY, OLIVIA CLAIRE (AUD)
Entity type:Individual
Prefix:DR
First Name:OLIVIA
Middle Name:CLAIRE
Last Name:GATELY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:OLIVIA
Other - Middle Name:CLAIRE
Other - Last Name:NESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2808 JANICE DR.
Mailing Address - Street 2:
Mailing Address - City:CABOT
Mailing Address - State:AR
Mailing Address - Zip Code:72023
Mailing Address - Country:US
Mailing Address - Phone:217-979-3036
Mailing Address - Fax:
Practice Address - Street 1:701 MARION ST STE 201
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-4833
Practice Address - Country:US
Practice Address - Phone:501-278-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-15
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR202197231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist