Doctor Name: | MR. ALAN OLSON |
NPI Number: | 1083703987 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC LAMFT |
License Number: | LPC 0200 |
Business Practice Address: | 10591 165th St W Lakeville, MN - 550443528 |
Business Phone Number: | 9528981133 |
Business Fax Number: | 9524356797 |
Mailing Address: | 10591 165th St W, LAKEVILLE |
State: | MN |
Postal Code: | 550443528 |
Phone Number: | 9528981133 |
Fax Number: | 9524356797 |
NPI Enumeration Date: | 10/11/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | LPC 0200 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | MN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |