Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | OT 136 | FL |
NPI | 1245268606 |
---|---|
Provider Name | Wendy J. Holt |
First Address | Vienna, VA 22180-4737 |
Second Address | St Augustine, FL 32084-5774 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 08/07/2007 |