Doctor Name: | DR. KEVIN SCOTT OLIN |
NPI Number: | 1043293632 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | 3354 |
Business Practice Address: | 288 N Ironwood Dr Suite 110 Apache Junction, AZ - 852203830 |
Business Phone Number: | 4809822356 |
Business Fax Number: | 4809822449 |
Mailing Address: | 288 N Ironwood Dr, Suite 110 APACHE JUNCTION |
State: | AZ |
Postal Code: | 852203830 |
Phone Number: | 4809822356 |
Fax Number: | 4809822449 |
NPI Enumeration Date: | 11/28/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 3354 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |