Provider Demographics
NPI:1861818973
Name:OLSON, SUSAN (MS, ABS)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:OLSON
Suffix:
Gender:F
Credentials:MS, ABS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 SW 89TH ST
Mailing Address - Street 2:APT 145
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-8523
Mailing Address - Country:US
Mailing Address - Phone:405-655-7393
Mailing Address - Fax:
Practice Address - Street 1:148 SW 89TH ST
Practice Address - Street 2:APT 145
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-8523
Practice Address - Country:US
Practice Address - Phone:405-655-7393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-13
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health