Individual
SAMANTHA SHADE HOLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
702 W DOLF ST, COLBY, WI 54421-9604
(715) 223-2352
Mailing address
10196 US HIGHWAY 10, MARSHFIELD, WI 54449-8622
(505) 634-8869
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
WI
Other
Enumeration date
10/25/2021
Last updated
11/01/2021
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