Healthcare Provider Details

I. General information

NPI: 1083666317
Provider Name (Legal Business Name): HOLLY ELISE VAN MEETEREN O.T.R. L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

184 HIGH ST STE 701
BOSTON MA
02110-3025
US

IV. Provider business mailing address

736 NUNU ST
KAILUA HI
96734-1633
US

V. Phone/Fax

Practice location:
  • Phone: 866-600-7598
  • Fax:
Mailing address:
  • Phone: 949-636-8969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number815
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number815
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: