Provider Demographics
NPI:1114337235
Name:OLSON, DENISE (CADC II)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:
Last Name:OLSON
Suffix:
Gender:F
Credentials:CADC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 NW 4TH ST
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-2078
Mailing Address - Country:US
Mailing Address - Phone:541-474-5191
Mailing Address - Fax:
Practice Address - Street 1:510 NW 4TH ST
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-2078
Practice Address - Country:US
Practice Address - Phone:541-474-5191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-28
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)