Healthcare Provider Details

I. General information

NPI: 1861209454
Provider Name (Legal Business Name): AARON JOHN OLSON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2024
Last Update Date: 12/17/2024
Certification Date: 12/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 S 550 E
OREM UT
84097-7136
US

IV. Provider business mailing address

114 W AUTUMN LN
SARATOGA SPRINGS UT
84045-2901
US

V. Phone/Fax

Practice location:
  • Phone: 801-368-1247
  • Fax:
Mailing address:
  • Phone: 801-368-1247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number7821253-6004
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: