Provider Demographics
NPI:1689063869
Name:DAVIS-OLSON, NATALIE (CBT)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:DAVIS-OLSON
Suffix:
Gender:F
Credentials:CBT
Other - Prefix:DR
Other - First Name:NATALIE
Other - Middle Name:
Other - Last Name:DAVIS-OLSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:910 PELZER HWY
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29642-2934
Mailing Address - Country:US
Mailing Address - Phone:864-800-2852
Mailing Address - Fax:
Practice Address - Street 1:910 PELZER HWY
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29642-2934
Practice Address - Country:US
Practice Address - Phone:864-671-0060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-12
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXL12327637OtherPASTORAL MEDICAL ASSOCIATION