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NPI Code Detail

MEDICARE: OLIVIA CHRISTENSON

MEDICARE: OLIVIA CHRISTENSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1407581119
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLIVIA CHRISTENSON
Provider Business Mailing Address
First Line : 9663 HUDSON BLVD N UNIT 1116
Second Line :
City : LAKE ELMO
State : MN
Zip : 55042-4517
Country : US
Telephone Number : 701-200-2924
Fax Number :
Provider Business Practice Location Address
First Line : 434 HAYWARD AVE N
Second Line :
City : OAKDALE
State : MN
Zip : 55128-5379
Country : US
Telephone Number : 651-739-2300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2022
Last Update Date : 07/18/2022

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Directions to “ OLIVIA CHRISTENSON ” Practice Location

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