Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OTT.200511 | LA |
NPI | 1003410259 |
---|---|
Provider Name | Holly Cameron |
First Address | Natchitoches, LA 71457-2509 |
Second Address | Natchitoches, LA 71457-6043 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2020 |
Last Update Date | 29/11/2020 |