Individual
THEODORE KENT OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1000 N OAK AVE, MARSHFIELD, WI 54449
(715) 389-3825
Mailing address
1000 N OAK AVE, MARSHFIELD, WI 54449-5777
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1675
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39092400
—
WI
Enumeration date
09/02/2006
Last updated
07/08/2007
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