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General NPI Number Information
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NPI Number | 1952404972
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Entity Type | Individual
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Provider Name | GAYLE OCTA BROWN OLSON LICSW
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Gender | Female
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Dates
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Enumeration Date | 09/06/2006
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Last Update Date | 03/02/2021
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Provider Practice Location Address
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Address Line | 1407 S STATE STREET
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City | NEW ULM
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State | MN
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Zip | 56073
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Country | US
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Telephone | 507-354-3181
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Fax | 507-354-3183
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Provider Business Mailing Address
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Address Line | 110 2ND ST S STE 301
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City | WAITE PARK
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State | MN
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Zip | 56387-1314
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Country | US
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Telephone | 320-252-2976
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Fax | 320-656-1570
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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 | 1405
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 1405
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License Number State | MN
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