Provider Demographics
NPI:1821363250
Name:OLSON, DANAE (MA, RD, LDN)
Entity Type:Individual
Prefix:
First Name:DANAE
Middle Name:
Last Name:OLSON
Suffix:
Gender:F
Credentials:MA, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2019 TRANQUIL PL
Mailing Address - Street 2:
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-9089
Mailing Address - Country:US
Mailing Address - Phone:828-426-8524
Mailing Address - Fax:828-426-8460
Practice Address - Street 1:2345 MORGANTON BLVD SW
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-4973
Practice Address - Country:US
Practice Address - Phone:828-426-8524
Practice Address - Fax:828-426-8460
Is Sole Proprietor?:No
Enumeration Date:2012-03-19
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL003942133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered