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Individual

MR. COLLIN MARK OLSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.A., CCC-SLP

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
11331224-4102
UT
235Z00000X
Speech-Language Pathologist
11331224-4104
UT

Other

Enumeration date
06/14/2019
Last updated
12/01/2021
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