Healthcare Provider Details

I. General information

NPI: 1770407603
Provider Name (Legal Business Name): LAURA OLSON LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1409 ASHLEY ST
LARAMIE WY
82070-4814
US

IV. Provider business mailing address

1409 ASHLEY ST
LARAMIE WY
82070-4814
US

V. Phone/Fax

Practice location:
  • Phone: 907-721-8094
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number890
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: