Individual
TISHA HOLLANBAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA /L
Contact information
Practice address
2410 JEFFERSON AVE, POINT PLEASANT, WV 25550-1528
(304) 675-7400
Mailing address
586 DULY RD, GALLIPOLIS, OH 45631-9401
(740) 441-7999
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
C1680
WV
Other
Enumeration date
08/31/2015
Last updated
09/20/2022
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