Provider Demographics
NPI:1841161346
Name:FOUTTY, OLIVIA SHAYE (MA SLP-CF)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:SHAYE
Last Name:FOUTTY
Suffix:
Gender:F
Credentials:MA SLP-CF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2714 AKRON RD
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-7933
Mailing Address - Country:US
Mailing Address - Phone:330-262-4449
Mailing Address - Fax:330-262-4449
Practice Address - Street 1:2714 AKRON RD
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-7933
Practice Address - Country:US
Practice Address - Phone:330-262-4449
Practice Address - Fax:330-262-4449
Is Sole Proprietor?:No
Enumeration Date:2025-09-16
Last Update Date:2025-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOND.20253178-SP235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist