Individual
MARY L OLSTAD HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
700 WEST AVE S, LA CROSSE, WI 54601-4783
(608) 782-9760
Mailing address
700 WEST AVE S, LA CROSSE, WI 54601-4783
(608) 782-9760
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2116
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39267800
—
WI
Enumeration date
06/15/2006
Last updated
05/07/2013
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