Provider Demographics
NPI:1992839815
Name:OLSON, RALPH BLAIR (LPC, LMFT)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:BLAIR
Last Name:OLSON
Suffix:
Gender:M
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 WILSON ST
Mailing Address - Street 2:
Mailing Address - City:ARKADELPHIA
Mailing Address - State:AR
Mailing Address - Zip Code:71923-4660
Mailing Address - Country:US
Mailing Address - Phone:870-246-8877
Mailing Address - Fax:870-230-5459
Practice Address - Street 1:1421 WILSON ST
Practice Address - Street 2:
Practice Address - City:ARKADELPHIA
Practice Address - State:AR
Practice Address - Zip Code:71923-4660
Practice Address - Country:US
Practice Address - Phone:870-246-8877
Practice Address - Fax:870-230-5459
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP8108201101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health