Doctor Name: | BARRY OLSON OLSON |
NPI Number: | 1023411774 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | BS |
License Number: | |
Business Practice Address: | 24460 Lyons Ave Santa Clarita, CA - 913212347 |
Business Phone Number: | 6612539400 |
Business Fax Number: | 6612539403 |
Mailing Address: | 6166 Vesper Ave, VAN NUYS |
State: | CA |
Postal Code: | 914112851 |
Phone Number: | 8189970141 |
Fax Number: | 8189970851 |
NPI Enumeration Date: | 10/08/2014 |
NPI Last Update Date: | 10/08/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |