Healthcare Provider Details

I. General information

NPI: 1003455726
Provider Name (Legal Business Name): KATIA MONIQUE THORSVIK OLSON RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2019
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9525 E DOUBLETREE RANCH RD STE 101
SCOTTSDALE AZ
85258-5538
US

IV. Provider business mailing address

27777 INKSTER RD STE 100
FARMINGTON HILLS MI
48334-5312
US

V. Phone/Fax

Practice location:
  • Phone: 480-488-3946
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-19-108924
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: