Individual
HOLLY KRYSTINE TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
275 CALEDONIA DR, OWOSSO, MI 48867
(989) 666-1606
Mailing address
3001 COPAS RD, OWOSSO, MI 48867-9609
(989) 666-1606
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202008091
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5202008091
—
MI
Enumeration date
03/02/2018
Last updated
03/02/2018
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