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General NPI Number Information
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NPI Number | 1699875971
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Entity Type | Individual
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Provider Name | PATRICIA ANN OLSON LICSW
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Gender | Female
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 11/23/2020
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Provider Practice Location Address
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Address Line | 205 W 2ND ST STE 431
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City | DULUTH
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State | MN
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Zip | 55802-1922
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Country | US
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Telephone | 218-310-8712
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Fax | 218-216-1226
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Provider Business Mailing Address
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Address Line | 205 W 2ND ST STE 431
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City | DULUTH
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State | MN
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Zip | 55802-1922
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Country | US
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Telephone | 218-310-8712
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Fax | 218-216-1226
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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 | 4302287
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License Number State | MN
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