Individual
NICOLE HOLTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
814 JACKSON STREET, STOUGHTON, WI 53589-1520
(608) 873-6448
Mailing address
814 JACKSON STREET, STOUGHTON, WI 53589-1520
(608) 873-6448
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4658027
WI
Other
Enumeration date
12/23/2008
Last updated
12/23/2008
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