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NPI Code Detail

MEDICARE: CRISTINE MARIE OLSON SLP

MEDICARE: CRISTINE MARIE OLSON SLP
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 Pathologist4143NM

General Provider Information

NPI Number : 1508939539
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRISTINE MARIE OLSON SLP
Provider Business Mailing Address
First Line : 301 PERKINS DR STE C
Second Line :
City : LAS CRUCES
State : NM
Zip : 88005-3248
Country : US
Telephone Number : 575-523-7243
Fax Number : 575-525-5641
Provider Business Practice Location Address
First Line : 1090 MED PARK DR
Second Line :
City : LAS CRUCES
State : NM
Zip : 88005-3236
Country : US
Telephone Number : 575-523-7243
Fax Number : 575-525-5641
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2006
Last Update Date : 06/12/2015

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Directions to “ CRISTINE MARIE OLSON SLP” Practice Location

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