Individual
HOLLY FALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
677 EAST STREET, BURLINGTON, WI 53105-1639
(626) 763-9531
Mailing address
677 EAST STREET, BURLINGTON, WI 53105
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5191
WI
Other
Enumeration date
04/07/2020
Last updated
04/07/2020
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