MEDICARE: LYNN J. HOLT OTRL

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	02515	MD

General Provider Information

NPI Number	:	1396029294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNN J. HOLT OTRL

Provider Business Mailing Address
First Line	:	6058B ESSEX HOUSE SQUARE
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22310-0000
Country	:	US
Telephone Number	:	301-821-0523
Fax Number	:

Provider Business Practice Location Address
First Line	:	6058B ESSEX HOUSE SQUARE
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22310-0000
Country	:	US
Telephone Number	:	301-821-0523
Fax Number	:

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

Provider Enumeration Date	:	10/11/2011
Last Update Date	:	10/11/2011

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