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NPI Code Detail

MEDICARE: MELISSA BETH OLSON

MEDICARE: MELISSA BETH OLSON
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1912865585
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA BETH OLSON
Provider Business Mailing Address
First Line : 2760 W PEORIA AVE # 1277
Second Line :
City : PHOENIX
State : AZ
Zip : 85029-5202
Country : US
Telephone Number : 626-339-4999
Fax Number :
Provider Business Practice Location Address
First Line : 2760 W PEORIA AVE # 1277
Second Line :
City : PHOENIX
State : AZ
Zip : 85029-5202
Country : US
Telephone Number : 626-339-4999
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2026
Last Update Date : 01/13/2026

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Directions to “ MELISSA BETH OLSON ” Practice Location

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