Provider Demographics
NPI:1669751806
Name:OLHEISER, ERIN J
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:J
Last Name:OLHEISER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 W NETHERWOOD ST STE 6B
Mailing Address - Street 2:
Mailing Address - City:OREGON
Mailing Address - State:WI
Mailing Address - Zip Code:53575-1100
Mailing Address - Country:US
Mailing Address - Phone:608-291-0107
Mailing Address - Fax:608-291-0107
Practice Address - Street 1:185 W NETHERWOOD ST STE 6B
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:WI
Practice Address - Zip Code:53575
Practice Address - Country:US
Practice Address - Phone:608-291-0107
Practice Address - Fax:608-291-0107
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-05
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4265-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional