Individual
ALEXANDRIA OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
405 W 15TH ST, PUEBLO, CO 81003-2743
(719) 584-7320
Mailing address
400 W 16TH ST, PUEBLO, CO 81003-2745
(719) 584-4000
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86116884
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
86116884
—
CO
Enumeration date
07/08/2020
Last updated
07/08/2020
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