Provider Demographics
NPI:1821025230
Name:OLSON, ANGELA (MSW)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:OLSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 548
Mailing Address - Street 2:
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-0548
Mailing Address - Country:US
Mailing Address - Phone:517-265-0229
Mailing Address - Fax:517-265-0829
Practice Address - Street 1:415 E KILBUCK ST
Practice Address - Street 2:
Practice Address - City:TECUMSEH
Practice Address - State:MI
Practice Address - Zip Code:49286-2073
Practice Address - Country:US
Practice Address - Phone:517-423-3887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010808111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical