Organization
DEPATMENT OF BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELLEN BRIDGET OLSEN L.P.T. (LICENSED PSYCHIATRIC TECHNICIAN)
(909) 598-6462
Entity
Organization
Contact information
Practice address
1300 E COOLEY DR, COLTON, CA 92324-3905
(909) 423-0750
Mailing address
1300 E COOLEY DR, COLTON, CA 92324-3905
(909) 423-0750
Taxonomy
Speciality
Code
Description
License number
State
284300000X
Special Hospital
Primary
32634
CA
Other
Enumeration date
06/08/2012
Last updated
06/08/2012
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