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NPI Code Detail

MEDICARE: MRS. OLIVIA NORRIS HOLLAND COTA/L

MEDICARE: MRS. OLIVIA NORRIS HOLLAND COTA/L
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
1224Z00000XOccupational Therapy Assistant
2224Z00000XOccupational Therapy Assistant11400NC

General Provider Information

NPI Number : 1295492965
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. OLIVIA NORRIS HOLLAND COTA/L
Provider Business Mailing Address
First Line : 104 HIDDEN CREEK DR
Second Line :
City : SWANSBORO
State : NC
Zip : 28584-8708
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1839 ONSLOW DR
Second Line :
City : JACKSONVILLE
State : NC
Zip : 28540-5906
Country : US
Telephone Number : 910-455-3610
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2021
Last Update Date : 11/19/2021

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