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NPI Code Detail

MEDICARE: MARYAM H HOLT OTD

MEDICARE: MARYAM H HOLT OTD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist0119009737VA

General Provider Information

NPI Number : 1023728334
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARYAM H HOLT OTD
Provider Business Mailing Address
First Line : PO BOX 412307
Second Line :
City : BOSTON
State : MA
Zip : 02241-2307
Country : US
Telephone Number : 888-830-4125
Fax Number :
Provider Business Practice Location Address
First Line : 1062 W MERCURY BLVD # B
Second Line :
City : HAMPTON
State : VA
Zip : 23666-1068
Country : US
Telephone Number : 757-644-0644
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2022
Last Update Date : 11/24/2025

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