Provider Demographics
NPI:1104580406
Name:OLSON, VICTORIA LYNN (MS, BCBA)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:LYNN
Last Name:OLSON
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3975 N NELLIS BLVD APT 1029
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89115-2796
Mailing Address - Country:US
Mailing Address - Phone:725-777-9109
Mailing Address - Fax:
Practice Address - Street 1:4325 N RANCHO DR STE 150
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-3439
Practice Address - Country:US
Practice Address - Phone:833-646-3222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-25
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1-23-70031103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst