Provider Demographics
NPI:1225427214
Name:OLAFSSON, MICHELE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:
Last Name:OLAFSSON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5120 GREENBERRY DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95841-4020
Mailing Address - Country:US
Mailing Address - Phone:916-337-7884
Mailing Address - Fax:
Practice Address - Street 1:5120 GREENBERRY DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95841-4020
Practice Address - Country:US
Practice Address - Phone:916-337-7884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-14
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5648225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist