MEDICARE: MAUREEN HOLDEN 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	1849	NC

General Provider Information

NPI Number	:	1851661417
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAUREEN HOLDEN OT

Provider Business Mailing Address
First Line	:	2222 SULLIVAN TRL
Second Line	:
City	:	EASTON
State	:	PA
Zip	:	18040-7958
Country	:	US
Telephone Number	:	610-991-2034
Fax Number	:	610-438-2046

Provider Business Practice Location Address
First Line	:	5326 PARK RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28209-3648
Country	:	US
Telephone Number	:	704-553-8700
Fax Number	:

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

Provider Enumeration Date	:	01/12/2012
Last Update Date	:	01/12/2012

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