Individual
MRS. AMY GERALDINE OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1215 E ORANGE ST, LAKELAND, FL 33801-5762
(863) 802-3800
(863) 802-0480
Mailing address
1215 E ORANGE ST, LAKELAND, FL 33801-5762
(863) 802-3800
(863) 802-0480
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT12452
FL
225XP0200X
Pediatric Occupational Therapist
OT12452
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15018301
CITRUS HMO IND ID
FL
05
—
891654300
—
FL
01
—
OT12452
OCCUPATIONAL THERAPY
FL
01
—
Y905L
BCBS FL
FL
Enumeration date
09/06/2006
Last updated
06/25/2008
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