Provider Demographics
NPI:1285941377
Name:OLSON, HEATHER (MA)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:OLSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 LOUDON RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-5601
Mailing Address - Country:US
Mailing Address - Phone:603-226-7516
Mailing Address - Fax:
Practice Address - Street 1:105 LOUDON RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-5601
Practice Address - Country:US
Practice Address - Phone:603-226-7516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-10
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor