| Doctor Name: | DR. JEFFREY L OLSON |
| NPI Number: | 1881795276 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSYD LP |
| License Number: | LP4532 |
| Business Practice Address: | 4891 Miller Trunk Hwy Suite 106 Hermantown, MN - 558111512 |
| Business Phone Number: | 2187222525 |
| Business Fax Number: | 2187221033 |
| Mailing Address: | 4891 Miller Trunk Hwy, Suite 106 HERMANTOWN |
| State: | MN |
| Postal Code: | 558111512 |
| Phone Number: | 2187222525 |
| Fax Number: | 2187221033 |
| NPI Enumeration Date: | 09/26/2006 |
| NPI Last Update Date: | 11/26/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | LP4532 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |