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Individual

LILA OLSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
11428 ROYAL AMBER WAY, RALEIGH, NC 27614-9896
(919) 618-1353
(919) 741-4741
Mailing address
1705 FAIRVIEW RD, RALEIGH, NC 27608-2413
(919) 618-1353
(919) 741-4741

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
A17722
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A17722
LISCENSED CLINICAL MENTAL HEALTH COUNSELOR
NC
Enumeration date
08/23/2022
Last updated
09/21/2022
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