Provider Demographics
NPI:1417059080
Name:OLSON, DARLENE JEAN (EDD)
Entity Type:Individual
Prefix:DR
First Name:DARLENE
Middle Name:JEAN
Last Name:OLSON
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 PATTERSON RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45419-3933
Mailing Address - Country:US
Mailing Address - Phone:937-294-3794
Mailing Address - Fax:937-293-3884
Practice Address - Street 1:1344 WOODMAN DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45432-3475
Practice Address - Country:US
Practice Address - Phone:937-294-3794
Practice Address - Fax:937-293-3884
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4656103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH458289000OtherMAGELLAN HEALTH SERVICES
OH000000189925OtherANTHEM
OH458289000OtherMAGELLAN HEALTH SERVICES