Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SHELLY OLSON
Active Sole ProprietorIntellectual Disabilities Residential Treatment Facility · DULUTH, MN
Registration Details
- NPI Number
- 1801293444
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Nov 25, 2014 (11.40460835775 yrs)
- Last Updated
- Nov 25, 2014
- License
-
1076151-1-HCBS (MN)
- Sole Proprietor
- Yes
Practice Information
- Address
-
5448 W ISLAND LAKE RDDULUTH, MN, 558038405Browse MN providers · Browse ZIP 55803
- Phone
- 2183930233
- Primary Specialty
-
Intellectual Disabilities Residential Treatment Facility
320600000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.