Healthcare Provider Details

I. General information

NPI: 1205697034
Provider Name (Legal Business Name): KEVIN S OLIN PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2024
Last Update Date: 09/28/2026
Certification Date: 01/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2266 S DOBSON RD STE 240
MESA AZ
85202-6488
US

IV. Provider business mailing address

9754 E TIMPANI LN
MESA AZ
85212-9133
US

V. Phone/Fax

Practice location:
  • Phone: 480-313-9561
  • Fax: 480-739-9065
Mailing address:
  • Phone: 480-313-9561
  • Fax: 480-739-9065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. KEVIN SCOTT OLIN
Title or Position: PSYCHOLOGIST
Credential: PH.D.
Phone: 480-720-7488