Provider Demographics
NPI:1952555757
Name:OLSON, TARA B (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:TARA
Middle Name:B
Last Name:OLSON
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 1:28 CHOIR LN
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-5722
Mailing Address - Country:US
Mailing Address - Phone:516-238-8894
Mailing Address - Fax:516-414-8542
Practice Address - Street 1:28 CHOIR LN
Practice Address - Street 2:
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-5722
Practice Address - Country:US
Practice Address - Phone:516-238-8894
Practice Address - Fax:516-414-8542
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-06
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010650-1225XL0004X, 225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XL0004XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistLow Vision
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation