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NPI Code Detail

MEDICARE: ANN MARIE OLSON LADC

MEDICARE:   ANN MARIE OLSON  LADC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor302868MN

General Provider Information

NPI Number : 1629590823
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANN MARIE OLSON LADC
Provider Business Mailing Address
First Line : 112 1ST ST W
Second Line :
City : BEMIDJI
State : MN
Zip : 56601-4002
Country : US
Telephone Number : 218-888-8032
Fax Number :
Provider Business Practice Location Address
First Line : 112 1ST ST W
Second Line :
City : BEMIDJI
State : MN
Zip : 56601-4002
Country : US
Telephone Number : 218-888-8032
Fax Number : 218-888-8033
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2017
Last Update Date : 09/15/2022

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Directions to “ ANN MARIE OLSON LADC” Practice Location

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