Individual
JESSICA HOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1301 E BROADWAY ST, MISSOULA, MT 59802-4905
(412) 721-9337
Mailing address
25117 SW PARKWAY AVE STE D, WILSONVILLE, OR 97070-9697
(412) 721-9337
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
2042
CA
224Z00000X
Occupational Therapy Assistant
OC60450841
WA
224Z00000X
Occupational Therapy Assistant
Primary
OTP-OTA-LIC-8614
MT
Other
Enumeration date
04/10/2014
Last updated
12/17/2021
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