Healthcare Provider Details

I. General information

NPI: 1093664591
Provider Name (Legal Business Name): HALLIE B OLSEN LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2026
Last Update Date: 01/27/2026
Certification Date: 01/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 E RIVERSIDE DR STE 200
SAINT GEORGE UT
84790-7065
US

IV. Provider business mailing address

136 E RIVERSIDE DR STE 200
SAINT GEORGE UT
84790-7065
US

V. Phone/Fax

Practice location:
  • Phone: 435-656-0234
  • Fax:
Mailing address:
  • Phone: 435-656-0234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number13922431-4701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: