Organization
HOLLY A. NELSON, PEDIATRIC OCCUPATIONAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOLLY NELSON OTR/L (OWNER)
(410) 882-1345
Entity
Organization
Contact information
Practice address
3811 CRESTVALE TER, BALTIMORE, MD 21236-5201
(410) 882-1345
Mailing address
3811 CRESTVALE TER, BALTIMORE, MD 21236-5201
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
03646
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KCN6HO
CAREFIRST BLUECROSS BLUE SHIELD NON-PARTICIPATING PROVIDER NUMBER
MD
Enumeration date
09/13/2012
Last updated
09/13/2012
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