Provider Demographics
NPI:1700134574
Name:OLSON, ELIZABETH AYER (PHD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:AYER
Last Name:OLSON
Suffix:
Gender:F
Credentials:PHD
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Mailing Address - Street 1:7 ESSEX GREEN DR., SUITE 63
Mailing Address - Street 2:NORTH SHORE NEUROPSYCHOLOGICAL SERVICES, LLC
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-2961
Mailing Address - Country:US
Mailing Address - Phone:857-383-0651
Mailing Address - Fax:781-990-3722
Practice Address - Street 1:7 ESSEX GREEN DR., SUITE 63
Practice Address - Street 2:NORTH SHORE NEUROPSYCHOLOGICAL SERVICES, LLC
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-2961
Practice Address - Country:US
Practice Address - Phone:857-383-0651
Practice Address - Fax:781-990-3722
Is Sole Proprietor?:No
Enumeration Date:2012-08-27
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA9564103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist