Provider Demographics
NPI:1669046090
Name:JULIE OLESKO LLC
Entity Type:Organization
Organization Name:JULIE OLESKO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:OLESKO
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:248-318-9118
Mailing Address - Street 1:300 N 5TH AVE STE 230
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-5504
Mailing Address - Country:US
Mailing Address - Phone:248-318-9118
Mailing Address - Fax:
Practice Address - Street 1:300 N 5TH AVE STE 230
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-5504
Practice Address - Country:US
Practice Address - Phone:248-318-9118
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-19
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty