Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | ||
N | 103G00000X | Clinical Psychologist | 2748 | OR |
N | 103TC0700X | Clinical Psychologist | 2748 | OR |
N | 103TC1900X | Counseling Psychologist |
NPI | 1013244599 |
---|---|
Provider Name | Dr. Randy Olander |
First Address | Roseburg, OR 97471-1800 |
Second Address | Roseburg, OR 97471-1800 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2009 |
Last Update Date | 08/01/2021 |