Individual
MICHELLE MARIE OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
600 YORK ST, MANITOWOC, WI 54220-6845
(920) 320-6750
(920) 682-1981
Mailing address
2300 WESTERN AVE, PO BOX 2170, MANITOWOC, WI 54221-2170
(920) 320-8667
(920) 320-8616
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
725-27
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40821500
—
WI
01
—
717459
T19 MANAGED HEALTH SERVIC
WI
Enumeration date
07/03/2006
Last updated
07/08/2007
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