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General NPI Number Information
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NPI Number | 1205535051
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Entity Type | Individual
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Provider Name | ELISE COURTNEY OLEKSIAK OTR
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Gender | Female
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Dates
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Enumeration Date | 03/01/2023
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Last Update Date | 06/19/2023
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Provider Practice Location Address
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Address Line | 91-750 FORT WEAVER RD
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City | EWA BEACH
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State | HI
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Zip | 96706-2596
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Country | US
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Telephone | 808-689-1290
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Fax |
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Provider Business Mailing Address
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Address Line | 15 REDWOOD RD
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City | MARTINSVILLE
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State | NJ
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Zip | 08836-2373
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT-2345-0
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License Number State | HI
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