Individual
GWENDOLYN J OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
1541 ANNEX RD, JEFFERSON, WI 53549-9803
(920) 674-3105
(920) 674-2359
Mailing address
1541 ANNEX RD, JEFFERSON, WI 53549-9803
(920) 674-3105
(920) 674-2359
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
131482
WI
1041C0700X
Clinical Social Worker
Primary
9781
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770198988
—
WI
Enumeration date
09/14/2020
Last updated
11/03/2021
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