Individual
MISTY DANIELLE OLSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
200 S MAIN ST, STE P3, POCATELLO, ID 83204-3261
(208) 251-6789
Mailing address
200 S MAIN ST, STE P3, POCATELLO, ID 83204-3261
(208) 251-6789
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-7813
ID
Other
Enumeration date
10/27/2020
Last updated
01/31/2024
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