Individual
ROBERT EDWARD OLT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
588 S PLUM ST, HAVANA, IL 62644-1374
(309) 253-7611
Mailing address
588 S PLUM ST, HAVANA, IL 62644-1374
(309) 253-7611
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071.008386
IL
Other
Enumeration date
01/29/2014
Last updated
01/29/2014
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