Individual
ANGELA HOLLANDSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9789 BIRDIE DR, STANWOOD, MI 49346-9786
(231) 598-2205
Mailing address
9789 BIRDIE DR, STANWOOD, MI 49346-9786
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202004692
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38-2481067
EMPLOYER ID #
MI
Enumeration date
06/19/2013
Last updated
06/19/2013
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