Provider Demographics
NPI:1023382132
Name:OLSON, LINDA ANN (PSYD)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:ANN
Last Name:OLSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 WEST MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:PLAINVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06062
Mailing Address - Country:US
Mailing Address - Phone:860-517-8557
Mailing Address - Fax:
Practice Address - Street 1:58 W MAIN ST
Practice Address - Street 2:
Practice Address - City:PLAINVILLE
Practice Address - State:CT
Practice Address - Zip Code:06062-1993
Practice Address - Country:US
Practice Address - Phone:860-517-8557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-07
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002473103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist