Provider Demographics
NPI:1750686887
Name:OLSON, LEAH M (SLP ASSISTANT)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:M
Last Name:OLSON
Suffix:
Gender:F
Credentials:SLP ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1480 OLSON RD
Mailing Address - Street 2:
Mailing Address - City:RAVENDEN
Mailing Address - State:AR
Mailing Address - Zip Code:72459-9012
Mailing Address - Country:US
Mailing Address - Phone:870-810-0068
Mailing Address - Fax:
Practice Address - Street 1:2103C OLD COUNTY RD
Practice Address - Street 2:
Practice Address - City:POCAHONTAS
Practice Address - State:AR
Practice Address - Zip Code:72455-4137
Practice Address - Country:US
Practice Address - Phone:870-248-1448
Practice Address - Fax:870-248-1450
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-20
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant