MEDICARE: OLSON SPEECH AND LANGUAGE P.C.

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	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1528154382
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OLSON SPEECH AND LANGUAGE P.C.

Provider Business Mailing Address
First Line	:	1919 OAKWELL FARMS PKWY
Second Line	:	STE 110
City	:	SAN ANTONIO
State	:	TX
Zip	:	78218-1726
Country	:	US
Telephone Number	:	210-857-7757
Fax Number	:	210-821-3727

Provider Business Practice Location Address
First Line	:	1919 OAKWELL FARMS PKWY
Second Line	:	STE 110
City	:	SAN ANTONIO
State	:	TX
Zip	:	78218-1726
Country	:	US
Telephone Number	:	210-857-7757
Fax Number	:	210-821-3727

Authorized Official
Title or Position	:	OWNER
Name	:	KATHERINE G OLSON
Credential	:	M.S., CCC-SLP
Telephone Number	:	210-857-7757

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	10/20/2009

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Directions to “OLSON SPEECH AND LANGUAGE P.C. ” Practice Location

Language	Start Address	Practice Location

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