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General NPI Number Information
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NPI Number | 1619889938
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Entity Type | Individual
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Provider Name | KELLIE G OLSON-BUDIG
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Gender | Female
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Dates
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Enumeration Date | 09/21/2026
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Last Update Date | 09/21/2026
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Provider Practice Location Address
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Address Line | 144 N KENWOOD ST
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City | CASPER
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State | WY
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Zip | 82601-2724
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Country | US
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Telephone | 307-267-9292
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Fax |
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Provider Business Mailing Address
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Address Line | 3615 COLE CREEK RD
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City | EVANSVILLE
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State | WY
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Zip | 82636-9809
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Country | US
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Telephone | 307-267-9292
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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 | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 14597400
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License Number State | WY
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