Provider Demographics
NPI:1740443498
Name:OLSON, BARBARA DEE (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:DEE
Last Name:OLSON
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16459 W SUNSET BLVD
Mailing Address - Street 2:4
Mailing Address - City:PACIFIC PALISADES
Mailing Address - State:CA
Mailing Address - Zip Code:90272-3323
Mailing Address - Country:US
Mailing Address - Phone:562-412-8353
Mailing Address - Fax:
Practice Address - Street 1:16459 W SUNSET BLVD
Practice Address - Street 2:4
Practice Address - City:PACIFIC PALISADES
Practice Address - State:CA
Practice Address - Zip Code:90272-3323
Practice Address - Country:US
Practice Address - Phone:562-412-8353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-02
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15160235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist