Individual
ABIGAIL O'HOLLAREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
22731 NEWMAN ST STE 100B, DEARBORN, MI 48124-2023
(313) 791-0616
Mailing address
11012 E 13 MILE RD STE 200, WARREN, MI 48093-2547
(313) 791-0616
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
236575
MEDICARE
MI
05
—
381958736
—
MI
Enumeration date
08/21/2018
Last updated
05/01/2023
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