Provider Demographics
NPI:1033272877
Name:OLSON, DEBORAH DENISE (MS LPC)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:DENISE
Last Name:OLSON
Suffix:
Gender:F
Credentials:MS LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 E GENEVA ST
Mailing Address - Street 2:
Mailing Address - City:DELAVAN
Mailing Address - State:WI
Mailing Address - Zip Code:53115-2108
Mailing Address - Country:US
Mailing Address - Phone:262-728-8908
Mailing Address - Fax:
Practice Address - Street 1:204 WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53186-4927
Practice Address - Country:US
Practice Address - Phone:262-542-6694
Practice Address - Fax:262-542-6213
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3027-125101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor