Provider Information for 1316125065
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MICHELLE M OLSON LCSW
Sex: Female
NPI: 1316125065
Last Updated: 2013-06-13
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||||||
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| NPI | 1316125065 | ||||||||||||||||
| Enumeration Date | 2008-02-05 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | NO | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | PO BOX 809 GOSHEN, IN 46527-0809 United States Phone: 574-533-1234 | Fax:574-537-2652 | ||||||||||||||||
| Primary Practice Address | 2600 OAKLAND AVE ELKHART, IN 46517-1533 United States Phone: 574-533-1234 | Fax:574-537-2652 | ||||||||||||||||
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