Provider Demographics
NPI:1073156717
Name:OLSON, ABIGAIL MARY JEAN
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:MARY JEAN
Last Name:OLSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1045 S BIRCH ST APT 119
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CO
Mailing Address - Zip Code:80246-2545
Mailing Address - Country:US
Mailing Address - Phone:507-272-5902
Mailing Address - Fax:
Practice Address - Street 1:12213 PECOS ST STE 500
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80234-3416
Practice Address - Country:US
Practice Address - Phone:720-379-6995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-25
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor