Individual provider · Type 1 NPI
Gary Olsen, SUDC
Addiction (Substance Use Disorder) Counselor · Provo, UT
NPI number
1487152203
Active
Practice location
750 N Freedom Blvd
Provo, UT 84601-1677
Fax (802) 373-0639
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 5264432-6006 (UT) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1487152203
Gary Olsen, SUDC's National Provider Identifier is 1487152203, issued on Jan 26, 2018. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Provo, UT. The record was last updated on Jun 10, 2020.