Provider Demographics
NPI:1134110034
Name:OLSON, TERESA B (PSYD)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:B
Last Name:OLSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8354 PRINCETON GLENDALE RD STE 118
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-2130
Mailing Address - Country:US
Mailing Address - Phone:513-860-3156
Mailing Address - Fax:513-860-3157
Practice Address - Street 1:8857 CINCINNATI DAYTON RD
Practice Address - Street 2:SUITE 104
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-7115
Practice Address - Country:US
Practice Address - Phone:513-860-3156
Practice Address - Fax:513-860-3157
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-31
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5073103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0220835Medicaid
OH0220835Medicaid