Provider Demographics
NPI:1629716790
Name:OLSON, ERIN LYNNETTE
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:LYNNETTE
Last Name:OLSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 W 103RD AVE APT 2013
Mailing Address - Street 2:
Mailing Address - City:FEDERAL HEIGHTS
Mailing Address - State:CO
Mailing Address - Zip Code:80260-8604
Mailing Address - Country:US
Mailing Address - Phone:720-229-7356
Mailing Address - Fax:
Practice Address - Street 1:743 HORIZON CT STE 220
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506-8716
Practice Address - Country:US
Practice Address - Phone:720-229-7356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-26
Last Update Date:2023-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0019526101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional