Individual
JAMES OLSEN III
Active
Individual
JAMES OLSEN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
6301004056
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042659
CIGNA
MI
01
—
1016060
MCLAREN HEALTH ADVANTAAGE
MI
Enumeration date
09/08/2006
Last updated
07/08/2007
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