MEDICARE: MS. HOLLY LYNN HARDAWAY OTR

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	46TR00050600	NJ

General Provider Information

NPI Number	:	1841255288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. HOLLY LYNN HARDAWAY OTR

Provider Business Mailing Address
First Line	:	7 PLEASANT PLAINS RD
Second Line	:
City	:	FRANKLIN PARK
State	:	NJ
Zip	:	08823-1307
Country	:	US
Telephone Number	:	732-398-1790
Fax Number	:

Provider Business Practice Location Address
First Line	:	7 PLEASANT PLAINS RD
Second Line	:
City	:	FRANKLIN PARK
State	:	NJ
Zip	:	08823-1307
Country	:	US
Telephone Number	:	732-398-1790
Fax Number	:

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

Provider Enumeration Date	:	04/19/2006
Last Update Date	:	02/18/2014

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