Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
N | 225C00000X | Rehabilitation Counselor |
NPI | 1003325739 |
---|---|
Provider Name | Danielle Brooke Olson I |
First Address | El Centro, CA 92243-2302 |
Second Address | El Centro, CA 92243-2302 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2017 |
Last Update Date | 10/12/2021 |