Provider Demographics
NPI:1013174804
Name:OLSON, HEATHER E (MD)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:E
Last Name:OLSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:300 LONGWOOD AVE
Mailing Address - Street 2:BOSTON CHILDREN HOSPITAL, FEGAN 9
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-5724
Mailing Address - Country:US
Mailing Address - Phone:617-355-8656
Mailing Address - Fax:617-730-0463
Practice Address - Street 1:300 LONGWOOD AVE
Practice Address - Street 2:BOSTON CHILDREN HOSPITAL, FEGAN 9
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5724
Practice Address - Country:US
Practice Address - Phone:617-355-8656
Practice Address - Fax:617-730-0463
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2424532084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology