Provider Demographics
NPI:1548240401
Name:OLSON, RITA KAYE (MS)
Entity Type:Individual
Prefix:MS
First Name:RITA
Middle Name:KAYE
Last Name:OLSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1727 TETON PASS
Mailing Address - Street 2:
Mailing Address - City:BROOKINGS
Mailing Address - State:SD
Mailing Address - Zip Code:57006-3626
Mailing Address - Country:US
Mailing Address - Phone:605-692-1614
Mailing Address - Fax:605-692-1614
Practice Address - Street 1:1727 TETON PASS
Practice Address - Street 2:
Practice Address - City:BROOKINGS
Practice Address - State:SD
Practice Address - Zip Code:57006-3626
Practice Address - Country:US
Practice Address - Phone:605-692-1614
Practice Address - Fax:605-692-1614
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-18
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC-MH2026101YM0800X
SDLMFT1055101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD9202570OtherDAKOTACARE
SD4997321OtherBCBS
SD9202570OtherDAKOTACARE