Provider Demographics
NPI:1942432604
Name:OLSON, KAREN C (PHD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:C
Last Name:OLSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 W THOMAS RD
Mailing Address - Street 2:SUITE 315
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-4419
Mailing Address - Country:US
Mailing Address - Phone:602-406-4516
Mailing Address - Fax:
Practice Address - Street 1:222 W THOMAS RD
Practice Address - Street 2:SUITE 315
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-4419
Practice Address - Country:US
Practice Address - Phone:602-406-4516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-13
Last Update Date:2009-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4027103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist