Provider Demographics
NPI:1952116493
Name:OLSON, SHAYLA M (CPS, CPPS)
Entity type:Individual
Prefix:
First Name:SHAYLA
Middle Name:M
Last Name:OLSON
Suffix:
Gender:F
Credentials:CPS, CPPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:947 STEELE ST
Mailing Address - Street 2:
Mailing Address - City:DE SOTO
Mailing Address - State:WI
Mailing Address - Zip Code:54624-8647
Mailing Address - Country:US
Mailing Address - Phone:734-790-3469
Mailing Address - Fax:
Practice Address - Street 1:947 STEELE ST
Practice Address - Street 2:
Practice Address - City:DE SOTO
Practice Address - State:WI
Practice Address - Zip Code:54624-8647
Practice Address - Country:US
Practice Address - Phone:734-790-3469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI172V00000X, 372500000X, 175T00000X, 372600000X, 373H00000X, 374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No172V00000XOther Service ProvidersCommunity Health Worker
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No374U00000XNursing Service Related ProvidersHome Health Aide