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1487152203
GARY OLSEN
PROVO, UT
NPI
1487152203
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: UT 5264432-6006)
Enumeration Date
2018-01-26
Last Update Date
2020-06-10
Business Address
GARY OLSEN SUDC
750 N FREEDOM BLVD
PROVO, UT 84601-1677
Phone number: 801-373-4760
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Mailing Address
GARY OLSEN SUDC
750 N FREEDOM BLVD
PROVO, UT 84601-1677
Phone number: 801-373-4760
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