Individual
KEVIN OLSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
215 CUSHMAN ST, FAIRBANKS, AK 99701-4639
(907) 374-1097
Mailing address
PO BOX 73004, FAIRBANKS, AK 99707-3004
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
06/22/2023
Last updated
06/22/2023
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