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Individual

MRS. NANCY MICHELE HOLLISTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
2650 N MOUNT JULIET RD, MOUNT JULIET, TN 37122-8015
(615) 758-4100
(615) 758-5450
Mailing address
1151 BIRDWELL DR, GALLATIN, TN 37066-3848
(615) 300-1253
(615) 758-5400

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1765
TN
224Z00000X
Occupational Therapy Assistant
248331
KY
224Z00000X
Occupational Therapy Assistant
OC60968376
WA
224Z00000X
Occupational Therapy Assistant
OTA-2279
NV
224Z00000X
Occupational Therapy Assistant
OTA.0001210
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1765
TN
Enumeration date
03/07/2016
Last updated
07/09/2019
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