Healthcare Provider Details

I. General information

NPI: 1386579076
Provider Name (Legal Business Name): SARAH E OLSEN PPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 W 8TH ST STE 4
GILLETTE WY
82716-4125
US

IV. Provider business mailing address

4108 SILVER SPUR AVE
GILLETTE WY
82718-7871
US

V. Phone/Fax

Practice location:
  • Phone: 307-257-3245
  • Fax:
Mailing address:
  • Phone: 307-257-3245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPPC-1652
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: