Individual
JOHN EDWARD OLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
400 VETERANS AVE, 122, BILOXI, MS 39531-2410
(228) 523-5773
Mailing address
400 VETERANS AVE, 122, BILOXI, MS 39531-2410
(228) 523-5773
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1478C
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1478C
SOCIAL WORKER
AL
Enumeration date
07/10/2006
Last updated
07/08/2007
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