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General NPI Number Information
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NPI Number | 1720163942
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Entity Type | Individual
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Provider Name | CAROLE C OLSON PSYD.
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Gender | Female
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 06/03/2019
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Provider Practice Location Address
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Address Line | 4 N. PINE STREET
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City | NINANTIC
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State | CT
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Zip | 06357
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Country | US
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Telephone | 401-862-9651
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Fax | 310-659-9217
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Provider Business Mailing Address
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Address Line | 4 N. PINE STREET
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City | NINANTIC
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State | CT
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Zip | 06357
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Country | US
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Telephone | 401-862-9651
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Fax | 310-659-9217
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 3661
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS00750
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License Number State | RI
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY22829
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License Number State | CA
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