Olivia M Bottalico, MA

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2204001437 Issued in VA

Practice address

6344 Beryl Rd
Alexandria, VA 22312-6351

Phone

(703) 914-7200

NPI assigned

Aug 7, 2024

Last updated

Nov 20, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1722988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1134959745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 HALF ST SE APT 416",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200034909",
            "telephone_number": "860-539-6624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6344 BERYL RD",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223126351",
            "telephone_number": "703-914-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTTALICO",
        "first_name": "OLIVIA",
        "middle_name": "M",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-07",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2204001437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anita L Boss, PSYD
• Elizabeth Ann Bostick, LCSW
• Leontyne Bostick, FNP
• Boston Medical Group- Virginia, P.C.
• Natalie Both, MSW
• Katherine Boucher
• Carla J Bouma, PT, DPT
• Amy Bourne, IBCLC
• Lisa S Bowen, NP-C
• Sheila Bowen

• Speech-Language Pathologist in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Speech-Language Pathologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.