Individual
MRS. HALEY SUSAN HOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
707 N BROADWAY, BALTIMORE, MD 21205-1888
(443) 923-1842
Mailing address
1741 ASHLAND AVE, BALTIMORE, MD 21205-1531
(443) 923-1842
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
05180
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
419800000
—
MD
01
—
62013201
CAREFIRST BCBS
MD
Enumeration date
03/05/2007
Last updated
10/21/2022
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