KENNETH EDGAR OLSON

SAN JOSE, CA
NPI1073708061
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2007-09-12
Last Update Date2007-09-12
Business Address
Mr. KENNETH EDGAR OLSON
4741 LAGO VISTA CIR
SAN JOSE, CA 95129-1440
Phone number: 408-243-5626
Mailing Address
Mr. KENNETH EDGAR OLSON
4741 LAGO VISTA CIR
SAN JOSE, CA 95129-1440
Phone number: 408-243-5626