Provider Demographics
NPI:1518954221
Name:OLSEN, ALISON A (PT)
Entity Type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:A
Last Name:OLSEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:ALISON
Other - Middle Name:A
Other - Last Name:OAKES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:15 MCCABE DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-5924
Mailing Address - Country:US
Mailing Address - Phone:775-788-5599
Mailing Address - Fax:775-788-5598
Practice Address - Street 1:15 MCCABE DR
Practice Address - Street 2:SUITE 101
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-5924
Practice Address - Country:US
Practice Address - Phone:775-788-5599
Practice Address - Fax:775-788-5598
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1143225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV003413414Medicaid
NV003413414Medicaid