Provider Demographics
NPI:1649753674
Name:OLNEY, ERIN (RBT)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:OLNEY
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:STEPHENSEN
Other - Last Name:STEFONEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1200 CONCORD AVE STE 185
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-5006
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5847 NE 122ND AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97230-1079
Practice Address - Country:US
Practice Address - Phone:971-339-7040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-14
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRBT-23-309083106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician