Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 5797951-2504 | UT |
Y | 103TC0700X | Clinical Psychologist | 5797951-2504 | UT |
NPI | 1013115724 |
---|---|
Provider Name | Dr. Chrisana Olson |
First Address | Salt Lake City, UT 84105-2432 |
Second Address | Salt Lake City, UT 84105-2432 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2007 |
Last Update Date | 08/07/2007 |