Provider Demographics
NPI:1013622364
Name:OLKO, TAYLOR LEE (OTR/L)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:LEE
Last Name:OLKO
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 1:1613 BELLAIRE AVE
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024-2515
Mailing Address - Country:US
Mailing Address - Phone:810-834-7277
Mailing Address - Fax:
Practice Address - Street 1:777 GOGUAC ST W STE B2
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-2097
Practice Address - Country:US
Practice Address - Phone:269-223-7786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-20
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI466443225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist