Doctor Name: | ANDREA OLSON |
NPI Number: | 1033538210 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 149004808 |
Business Practice Address: | 5334 Williams Dr Roscoe, IL - 610737320 |
Business Phone Number: | 8158710957 |
Business Fax Number: | 8668136462 |
Mailing Address: | 5334 Williams Dr, ROSCOE |
State: | IL |
Postal Code: | 610737320 |
Phone Number: | 8158710957 |
Fax Number: | 8668136462 |
NPI Enumeration Date: | 04/15/2014 |
NPI Last Update Date: | 03/24/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 149004808 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |