Individual
LISA MICHELLE HOLLOWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT, MHL, CAPS
Contact information
Practice address
9328 WOOD DUCK DR, FORT WORTH, TX 76118-7784
(817) 891-3255
Mailing address
9328 WOOD DUCK DR, FORT WORTH, TX 76118-7784
(817) 891-3255
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
104860
TX
Other
Enumeration date
08/05/2020
Last updated
08/05/2020
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