Healthcare Provider Details

I. General information

NPI: 1356250286
Provider Name (Legal Business Name): DANIELLE OLSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DANIELLE SMITH M.S., CCC-SLP

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4331 BELLA VISTA DR
LONGMONT CO
80503-4166
US

IV. Provider business mailing address

4331 BELLA VISTA DR
LONGMONT CO
80503-4166
US

V. Phone/Fax

Practice location:
  • Phone: 303-304-7884
  • Fax:
Mailing address:
  • Phone: 303-304-7884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number14532381
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: