Healthcare Provider Details

I. General information

NPI: 1598335424
Provider Name (Legal Business Name): EMILY OLER MOTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY OLER

II. Dates (important events)

Enumeration Date: 07/01/2021
Last Update Date: 07/01/2021
Certification Date: 06/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20-30 BEAVER RD
WETHERSFIELD CT
06109-2243
US

IV. Provider business mailing address

45 SILKEY RD
NORTH GRANBY CT
06060-1419
US

V. Phone/Fax

Practice location:
  • Phone: 860-529-0023
  • Fax:
Mailing address:
  • Phone: 860-819-4913
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number003450
License Number StateCT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: