Provider Demographics
NPI:1891477865
Name:OLSON, CHRISTOPHER RICHARD
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:RICHARD
Last Name:OLSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3230 W WILDWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68801-9609
Mailing Address - Country:US
Mailing Address - Phone:308-381-8851
Mailing Address - Fax:308-381-8853
Practice Address - Street 1:3230 W WILDWOOD DR
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68801-9609
Practice Address - Country:US
Practice Address - Phone:308-381-8851
Practice Address - Fax:308-381-8853
Is Sole Proprietor?:No
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician