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General NPI Number Information
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NPI Number | 1043372261
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Entity Type | Individual
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Provider Name | DEBORAH J OLSON LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 1707 MAIN ST
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City | LA CROSSE
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State | WI
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Zip | 54601-4200
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Country | US
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Telephone | 608-785-0001
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Fax | 608-785-0002
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Provider Business Mailing Address
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Address Line | 66 E 3RD ST 201
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City | WINONA
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State | MN
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Zip | 55987-3478
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Country | US
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Telephone | 507-452-7292
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Fax | 507-457-9887
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 4256 - 123
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License Number State | WI
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