| NPI | 1295444685 |
|---|---|
| Former Name | SHELBY R OLSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 305153) |
| Enumeration Date | 2022-11-15 |
| Last Update Date | 2022-11-15 |