Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OP002759L | PA |
NPI | 1023625340 |
---|---|
Provider Name | Holly Ann Taylor |
First Address | Knoxville, TN 37932-3347 |
Second Address | Hanover, PA 17331-9141 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2020 |
Last Update Date | 30/09/2020 |