Provider Demographics
NPI:1124522602
Name:OLESKI, AUDREY D (OTRL)
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:D
Last Name:OLESKI
Suffix:
Gender:
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 BYRON RD
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48855-6772
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:215 E MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:NORTHVILLE
Practice Address - State:MI
Practice Address - Zip Code:48167-1681
Practice Address - Country:US
Practice Address - Phone:248-349-9339
Practice Address - Fax:248-349-9342
Is Sole Proprietor?:No
Enumeration Date:2018-03-20
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201008041225X00000X, 225X00000X
225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist