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Individual

MRS. JACQUELINE MICHELLE HOLNESS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1835 N CENTRAL AVE, VALLEY STREAM, NY 11580-1034
(516) 285-8310
Mailing address
700 LAWRENCE ST, ELMONT, NY 11003-4617
(516) 561-3304
(516) 561-3304

Taxonomy

Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
003894
NY
225XP0200X
Pediatric Occupational Therapist
003894
NY

Other

Enumeration date
09/25/2011
Last updated
09/25/2011
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