Provider Demographics
NPI:1033096599
Name:OLSON, SUSAN ABIGAIL
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:ABIGAIL
Last Name:OLSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 BRIDGEPORT WAY APT 317
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-1966
Mailing Address - Country:US
Mailing Address - Phone:757-304-7563
Mailing Address - Fax:
Practice Address - Street 1:7025 HARBOUR VIEW BLVD STE 108B
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-2764
Practice Address - Country:US
Practice Address - Phone:757-974-8282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician