MEDICARE: DANIEL HOULIHAN OT

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
1	225X00000X	Occupational Therapist	0119004103	VA

General Provider Information

NPI Number	:	1104802776
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL HOULIHAN OT

Provider Business Mailing Address
First Line	:	PSC 561 BOX 1822
Second Line	:
City	:	FPO
State	:	AP
Zip	:	96310
Country	:	JP
Telephone Number	:	011942534562
Fax Number	:

Provider Business Practice Location Address
First Line	:	BRANCH MEDICAL CLINIC / EDIS
Second Line	:	PSC 561 BOX 1877
City	:	FPO
State	:	AP
Zip	:	96310
Country	:	JP
Telephone Number	:	011942534562
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2005
Last Update Date	:	08/17/2022

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