Individual
COURTNEY M HOLLOWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2101 JAMES ST, LAWRENCEVILLE, IL 62439-2027
(618) 943-3444
Mailing address
402 N JACKSON ST, PALESTINE, IL 62451-1322
(812) 480-8079
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.005072
IL
Other
Enumeration date
02/09/2019
Last updated
02/09/2019
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