MEDICARE: MALIA MONICA OLSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	170300000X	Genetic Counselor (M.S.)	14235349-3601	UT

General Provider Information

NPI Number	:	1013844828
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MALIA MONICA OLSON

Provider Business Mailing Address
First Line	:	379 E 1ST AVE APT 3G
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84103-6006
Country	:	US
Telephone Number	:	970-497-0506
Fax Number	:

Provider Business Practice Location Address
First Line	:	295 S CHIPETA WAY
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84108-1287
Country	:	US
Telephone Number	:	801-587-7400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/06/2026
Last Update Date	:	05/06/2026

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