Individual
SHANE OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7641 E GUADALUPE RD STE B106, MESA, AZ 85212-9627
(623) 273-6186
Mailing address
5141 HAWTHORNE DR APT I, WEST DES MOINES, IA 50265-6958
(480) 220-3268
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-17-28181
AZ
Other
Enumeration date
01/17/2018
Last updated
10/14/2024
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