Provider Demographics
NPI:1497721658
Name:ARRUFAT-TOBON, OLGA R (ICSW)
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:R
Last Name:ARRUFAT-TOBON
Suffix:
Gender:F
Credentials:ICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7974 UW HEALTH CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-5531
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3209 DRYDEN DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-3015
Practice Address - Country:US
Practice Address - Phone:608-241-9020
Practice Address - Fax:608-241-0857
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI67781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical