Individual
ELIZABETH ANNETTE HOLLOWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
8800 E 59TH ST, RAYTOWN, MO 64133-3702
(816) 353-9254
Mailing address
8800 E 59TH ST, RAYTOWN, MO 64133-3702
(816) 353-9254
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
000792
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000792
MISSOURI STATE LISCENSE
MO
Enumeration date
02/10/2011
Last updated
02/10/2011
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