Doctor Name: | DWIGHT E. OLSON |
NPI Number: | 1962602037 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | LCSW 1449 |
Business Practice Address: | 2480 Highway 52 Payette, ID - 836615536 |
Business Phone Number: | 2086429222 |
Business Fax Number: | 2086429224 |
Mailing Address: | 2480 Highway 52, PAYETTE |
State: | ID |
Postal Code: | 836615536 |
Phone Number: | 2086429222 |
Fax Number: | 2086429224 |
NPI Enumeration Date: | 07/18/2007 |
NPI Last Update Date: | 07/18/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | LCSW 1449 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OR |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |