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Individual

MRS. AMY GERALDINE OLSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

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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