Provider Demographics
NPI:1598274474
Name:OLSZEWSKI, JO ALENE A (COTA)
Entity Type:Individual
Prefix:
First Name:JO ALENE
Middle Name:A
Last Name:OLSZEWSKI
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 REVOLUTION MILL DR APT 238
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-5685
Mailing Address - Country:US
Mailing Address - Phone:336-682-8071
Mailing Address - Fax:
Practice Address - Street 1:6100 W FRIENDLY AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-4160
Practice Address - Country:US
Practice Address - Phone:336-292-9952
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1860224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant