Doctor Name: | PAMELA M OLSON |
NPI Number: | 1558793604 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | 6089 |
Business Practice Address: | 355 River Rd Grand Rapids, MN - 557443785 |
Business Phone Number: | 2189997213 |
Business Fax Number: | 2189997213 |
Mailing Address: | 7551 9th St N, Suite 100 OAKDALE |
State: | MN |
Postal Code: | 551286629 |
Phone Number: | 6517484338 |
Fax Number: | |
NPI Enumeration Date: | 07/31/2013 |
NPI Last Update Date: | 10/03/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 6089 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |