| Doctor Name: | NICOLETTE JOY OLSEN |
| NPI Number: | 1992010581 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CMHC |
| License Number: | 6822584-6004 |
| Business Practice Address: | 262 East Highway Montezuma Creek, UT - 845340130 |
| Business Phone Number: | 4356513700 |
| Business Fax Number: | 4356513376 |
| Mailing Address: | Po Box 130, MONTEZUMA CREEK |
| State: | UT |
| Postal Code: | 845340130 |
| Phone Number: | 4356513700 |
| Fax Number: | 4356513376 |
| NPI Enumeration Date: | 08/08/2010 |
| NPI Last Update Date: | 02/06/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 6822584-6004 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |