Individual
JUDITH K. OLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
526 REGENCY DR, LARAMIE, WY 82070-5106
(307) 745-8475
(307) 745-5138
Mailing address
526 REGENCY DR, LARAMIE, WY 82070-5106
(307) 745-8475
(307) 745-5138
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
75
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
138809
MHN
WY
01
—
830277301 82070 A001
TRICARE
WY
01
—
830277301-001
MBA
WY
01
—
OLS305030
BLUECROSS/BLUESHIELD
WY
Enumeration date
09/21/2006
Last updated
10/31/2007
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