Individual
TERRY OLSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
109 S BULLARD ST, SILVER CITY, NM 88061-5313
(575) 519-2629
Mailing address
109 S BULLARD ST, SILVER CITY, NM 88061-5313
(575) 519-2629
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
000000
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
26209233
—
NM
Enumeration date
11/01/2013
Last updated
11/01/2013
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