Healthcare Provider Details

I. General information

NPI: 1639670136
Provider Name (Legal Business Name): OLIVIA LYNN HO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2018
Last Update Date: 08/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 3RD AVE FL 5
NEW YORK NY
10017-5731
US

IV. Provider business mailing address

305 NE LOOP 820 BUSINESS TOWER 1, SUITE 200
HURST TX
76053
US

V. Phone/Fax

Practice location:
  • Phone: 212-922-1001
  • Fax:
Mailing address:
  • Phone: 817-292-8787
  • Fax: 817-789-6849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number118906
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number023624
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: