Doctor Name: | REBECCA OLSON |
NPI Number: | 1013321413 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMHC |
License Number: | 073037 |
Business Practice Address: | 111 Avenue O W Fort Dodge, IA - 505015634 |
Business Phone Number: | 5155732193 |
Business Fax Number: | |
Mailing Address: | 111 Avenue O W, FORT DODGE |
State: | IA |
Postal Code: | 505015634 |
Phone Number: | 5155732193 |
Fax Number: | |
NPI Enumeration Date: | 06/13/2014 |
NPI Last Update Date: | 06/13/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 073037 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |