Individual
DR. ROGER OLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
13177 W PERSIMMON LN STE 102, BOISE, ID 83713-1986
(208) 938-1236
Mailing address
PO BOX 140037, BOISE, ID 83714-0037
(208) 938-1236
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY-385
ID
Other
Enumeration date
01/16/2007
Last updated
07/08/2007
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