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NPI 1689802902

NPI 1689802902 : JONI L OLSON MT-BC, WMTR : EAU CLAIRE, WI

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General NPI Number Information
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    NPI Number           |    1689802902
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    Entity Type          |    Individual 
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    Provider Name        |    JONI L OLSON MT-BC, WMTR
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/25/2009
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    Last Update Date     |    06/25/2009
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Provider Practice Location Address
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    Address Line         |    4121 LARK AVE 
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    City                 |    EAU CLAIRE
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    State                |    WI
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    Zip                  |    54703-0459
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    Country              |    US
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    Telephone            |    715-210-4494
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4121 LARK AVE 
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    City                 |    EAU CLAIRE
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    State                |    WI
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    Zip                  |    54703-0459
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    Country              |    US
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    Telephone            |    715-210-4494
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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        |    225A00000X
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    Taxonomy Name        |    Music Therapist
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    License Number       |    89-038
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    License Number State |    WI
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