Provider Demographics
NPI:1174377972
Name:ROSOL, OLIVIA MARIE (EDS, MS, NCSP)
Entity type:Individual
Prefix:MRS
First Name:OLIVIA
Middle Name:MARIE
Last Name:ROSOL
Suffix:
Gender:F
Credentials:EDS, MS, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 S 131ST ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-2918
Mailing Address - Country:US
Mailing Address - Phone:402-709-8738
Mailing Address - Fax:
Practice Address - Street 1:804 S 131ST ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-2918
Practice Address - Country:US
Practice Address - Phone:402-709-8738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK447270103TS0200X
FL1427123103TS0200X
NE20240003760103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool