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General NPI Number Information
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NPI Number | 1477809366
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Entity Type | Individual
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Provider Name | MARIE L OLSEN
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Gender | Female
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Dates
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Enumeration Date | 07/27/2012
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Last Update Date | 01/04/2024
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Provider Practice Location Address
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Address Line | 200 PARK ST
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City | MORRISVILLE
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State | VT
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Zip | 05661-9098
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Country | US
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Telephone | 802-917-3183
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3
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City | NORTH HYDE PARK
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State | VT
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Zip | 05665-0003
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Country | US
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Telephone | 802-917-3183
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 068.0063061
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License Number State | VT
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