Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 1934 | NH |
NPI | 1003079336 |
---|---|
Provider Name | Ms. Jennifer Lynn Holland |
First Address | Somersworth, NH 03878-2309 |
Second Address | Concord, NH 03301-7539 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2008 |
Last Update Date | 07/07/2008 |