Provider Demographics
NPI:1841599750
Name:OLSON, DIANE LYNN (MS)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:LYNN
Last Name:OLSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:DIANE
Other - Middle Name:LYNN
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1096 APPLE AVE
Mailing Address - Street 2:
Mailing Address - City:AMERY
Mailing Address - State:WI
Mailing Address - Zip Code:54001-1707
Mailing Address - Country:US
Mailing Address - Phone:715-268-5404
Mailing Address - Fax:715-268-6103
Practice Address - Street 1:1096 APPLE AVE
Practice Address - Street 2:
Practice Address - City:AMERY
Practice Address - State:WI
Practice Address - Zip Code:54001-1707
Practice Address - Country:US
Practice Address - Phone:715-268-5404
Practice Address - Fax:715-268-6103
Is Sole Proprietor?:No
Enumeration Date:2011-03-17
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health