Healthcare Provider Details

I. General information

NPI: 1790938934
Provider Name (Legal Business Name): DENISE OLIN, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2008
Last Update Date: 03/12/2024
Certification Date: 03/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3938 ROUTE 7A
ARLINGTON VT
05250-4456
US

IV. Provider business mailing address

PO BOX 431
ARLINGTON VT
05250-0431
US

V. Phone/Fax

Practice location:
  • Phone: 530-888-8037
  • Fax: 888-357-3255
Mailing address:
  • Phone: 530-888-8037
  • Fax: 888-357-3255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number20480
License Number StateCA

VIII. Authorized Official

Name: DENISE OLIN
Title or Position: CLINICAL PSYCHOLOGIST
Credential: PSY.D.
Phone: 530-888-8037