Provider Demographics
NPI:1366566820
Name:OLSON, BETSEY M (EDD)
Entity type:Individual
Prefix:
First Name:BETSEY
Middle Name:M
Last Name:OLSON
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 SHEDD HILL RD
Mailing Address - Street 2:
Mailing Address - City:STODDARD
Mailing Address - State:NH
Mailing Address - Zip Code:03464-4423
Mailing Address - Country:US
Mailing Address - Phone:603-446-2390
Mailing Address - Fax:
Practice Address - Street 1:43 SHEDD HILL RD
Practice Address - Street 2:
Practice Address - City:STODDARD
Practice Address - State:NH
Practice Address - Zip Code:03464-4423
Practice Address - Country:US
Practice Address - Phone:603-446-2390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH485103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist