Provider Demographics
NPI:1225899370
Name:OLSON, ANGEL ANN (MSW)
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:ANN
Last Name:OLSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 930155
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:WI
Mailing Address - Zip Code:53593-0155
Mailing Address - Country:US
Mailing Address - Phone:608-982-7790
Mailing Address - Fax:608-716-3156
Practice Address - Street 1:103 RAILWAY AVE
Practice Address - Street 2:
Practice Address - City:SOLDIERS GROVE
Practice Address - State:WI
Practice Address - Zip Code:54655-7063
Practice Address - Country:US
Practice Address - Phone:608-293-0662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI20001101YA0400X
WI134338104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)