Provider Demographics
NPI:1649639873
Name:RAMIREZ-OLSON, JASMYNE JULIA
Entity type:Individual
Prefix:
First Name:JASMYNE
Middle Name:JULIA
Last Name:RAMIREZ-OLSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JASMYNE
Other - Middle Name:JULIA
Other - Last Name:RAMIREZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LICSW
Mailing Address - Street 1:241 CROCKER AVE N
Mailing Address - Street 2:
Mailing Address - City:THIEF RIVER FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56701-2314
Mailing Address - Country:US
Mailing Address - Phone:218-686-8987
Mailing Address - Fax:
Practice Address - Street 1:1165 S COLUMBIA RD STE D
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-4007
Practice Address - Country:US
Practice Address - Phone:218-686-8987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-16
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN225061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical