Doctor Name: | AMANDA OLSON |
NPI Number: | 1558794099 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMHC |
License Number: | 001653 |
Business Practice Address: | 3726 450th Ave Emmetsburg, IA - 505368584 |
Business Phone Number: | 7128523101 |
Business Fax Number: | 7128523100 |
Mailing Address: | 1800 19th St, ROCK VALLEY |
State: | IA |
Postal Code: | 512471037 |
Phone Number: | 7124763281 |
Fax Number: | 7124762970 |
NPI Enumeration Date: | 08/20/2013 |
NPI Last Update Date: | 08/20/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 001653 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |