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NPI Code Detail

MEDICARE: MRS. JULIE ANN OLSON MSW

MEDICARE: MRS. JULIE ANN OLSON MSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker290WY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1307948OTHERWYBS

General Provider Information

NPI Number : 1962400085
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JULIE ANN OLSON MSW
Provider Business Mailing Address
First Line : 2526 SEYMOUR AVE
Second Line :
City : CHEYENNE
State : WY
Zip : 82001-3159
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2526 SEYMOUR AVE
Second Line :
City : CHEYENNE
State : WY
Zip : 82001-3159
Country : US
Telephone Number : 307-634-9653
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2005
Last Update Date : 04/25/2008

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