Individual
MARY OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
490 N DIAMOND AVE, CANON CITY, CO 81212-2521
(719) 276-6174
Mailing address
101 N 14TH ST, CANON CITY, CO 81212-3564
(719) 276-5717
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
268405
CO
Other
Enumeration date
01/24/2024
Last updated
01/24/2024
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