Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 5201006588 | MI |
NPI | 1164661310 |
---|---|
Provider Name | Mrs. Sharon Renelee Holt |
First Address | Bath, MI 48808-9737 |
Second Address | East Lansing, MI 48823-7755 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2009 |
Last Update Date | 11/02/2009 |