Individual
STEPHANIE OLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.A.
Contact information
Practice address
150 SHOUP AVE, IDAHO FALLS, ID 83402-3657
(208) 528-4065
Mailing address
2785 EAGLE DR, B-105, AMMON, ID 83406-5711
(208) 528-4065
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
02/29/2016
Last updated
02/29/2016
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