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1073708061
KENNETH EDGAR OLSON
SAN JOSE, CA
NPI
1073708061
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2007-09-12
Last Update Date
2007-09-12
Business Address
Mr. KENNETH EDGAR OLSON
4741 LAGO VISTA CIR
SAN JOSE, CA 95129-1440
Phone number: 408-243-5626
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Mailing Address
Mr. KENNETH EDGAR OLSON
4741 LAGO VISTA CIR
SAN JOSE, CA 95129-1440
Phone number: 408-243-5626
Copy
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