Provider Demographics
NPI:1548548852
Name:ROLFE, ESTHER LEA (COTA)
Entity type:Individual
Prefix:MRS
First Name:ESTHER
Middle Name:LEA
Last Name:ROLFE
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 1:1426 N SUPERIOR ST
Mailing Address - Street 2:APT. 3
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911-3645
Mailing Address - Country:US
Mailing Address - Phone:920-574-8807
Mailing Address - Fax:
Practice Address - Street 1:1426 N SUPERIOR ST
Practice Address - Street 2:APT. 3
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911-3645
Practice Address - Country:US
Practice Address - Phone:920-574-8807
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-03
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4816-027224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant