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General NPI Number Information
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NPI Number | 1104383801
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Entity Type | Individual
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Provider Name | HOLLY NITTA OT
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Gender | Female
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Dates
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Enumeration Date | 02/28/2019
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Last Update Date | 02/17/2022
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Provider Practice Location Address
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Address Line | 2230 LILIHA ST
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City | HONOLULU
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State | HI
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Zip | 96817-1697
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Country | US
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Telephone | 808-554-7600
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Fax |
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Provider Business Mailing Address
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Address Line | 13609 CALIFORNIA ST STE 200
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City | OMAHA
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State | NE
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Zip | 68154-5245
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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