Provider Demographics
NPI:1003185232
Name:OLSON, LINDSAY ELIZABETH
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:ELIZABETH
Last Name:OLSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:ELIZABETH
Other - Last Name:HOLST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5279 KYLER AVE NE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ALBERTVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55301-4634
Mailing Address - Country:US
Mailing Address - Phone:763-951-3091
Mailing Address - Fax:763-951-3097
Practice Address - Street 1:5279 KYLER AVE NE
Practice Address - Street 2:SUITE 110
Practice Address - City:ALBERTVILLE
Practice Address - State:MN
Practice Address - Zip Code:55301-4634
Practice Address - Country:US
Practice Address - Phone:763-951-3091
Practice Address - Fax:763-951-3097
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-16
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist