Individual
FREDERICK J. OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2 SPRINGBROOK DR, BIDDEFORD, ME 04005-9443
(207) 282-1500
(207) 282-2581
Mailing address
78 ATLANTIC PL, SOUTH PORTLAND, ME 04106-2316
(207) 842-7701
(207) 842-7773
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC4696
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
250610099
—
ME
05
—
307930099
—
ME
Enumeration date
08/12/2006
Last updated
11/05/2012
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