Healthcare Provider Details

I. General information

NPI: 1720697766
Provider Name (Legal Business Name): ANGELA OLSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGELA KURLE

II. Dates (important events)

Enumeration Date: 07/27/2020
Last Update Date: 02/09/2026
Certification Date: 02/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

958 N 200 E
SPANISH FORK UT
84660-1247
US

IV. Provider business mailing address

1790 N STATE ST
OREM UT
84057-2025
US

V. Phone/Fax

Practice location:
  • Phone: 801-224-2313
  • Fax: 801-224-4475
Mailing address:
  • Phone: 801-224-8255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number118291836004
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: