Most Relevant Information
Provider Data
| NPI Number: | 1003230269 |
| Provider Name: | LORI OLSON IMH |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | IMH 9229 |
Most Important Dates
| Enumeration Date: | 02/09/2014 |
| Last Updated: | 02/09/2014 |
Provider Practice Location
3400 TAMIAMI TRL
SUITE 204
PORT CHARLOTTE
FL
339528102
Practice Location Phone/Fax
| Phone: | 9416290440 |
| Fax: |
Provider Mailing Location
3400 TAMIAMI TRL
SUITE 204
PORT CHARLOTTE
FL
339528102
Provider Mailing Phone/Fax
| Phone: | 9416290440 |
| Fax: |