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NPI Code Detail

MEDICARE: CLARA OLSON SLP-CCC

MEDICARE: CLARA OLSON SLP-CCC
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
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1265364392
Entity Type Code : Individual
Provider Name (Legal Business Name) : CLARA OLSON SLP-CCC
Provider Business Mailing Address
First Line : 26701 HALF CIRCLE CT
Second Line :
City : WYOMING
State : MN
Zip : 55092-8394
Country : US
Telephone Number : 651-587-5990
Fax Number :
Provider Business Practice Location Address
First Line : 70 COUNTY ROAD B2 W
Second Line :
City : LITTLE CANADA
State : MN
Zip : 55117-1402
Country : US
Telephone Number : 651-415-5622
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2026
Last Update Date : 06/02/2026

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Directions to “ CLARA OLSON SLP-CCC” Practice Location

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