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General NPI Number Information
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NPI Number | 1336458363
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Entity Type | Individual
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Provider Name | EMMY J. OLSON B.A./SLP-A
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Gender | Female
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Dates
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Enumeration Date | 09/24/2010
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Last Update Date | 12/17/2010
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Provider Practice Location Address
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Address Line | 3117 LITHIA PINECREST RD
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City | VALRICO
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State | FL
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Zip | 33596-5632
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Country | US
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Telephone | 813-662-1106
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Fax |
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Provider Business Mailing Address
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Address Line | 208 DRAGONS FIRE PL
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City | VALRICO
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State | FL
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Zip | 33594-3341
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Country | US
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Telephone | 813-546-3886
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | SI 1817
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number | SI 1817
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License Number State | FL
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