Individual
KATHERINE HOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA, CLT
Contact information
Practice address
2448 S 102ND ST STE 340, MILWAUKEE, WI 53227-2147
(414) 329-2500
Mailing address
845 OJIBWE PATH, KEWASKUM, WI 53040-9357
(262) 305-2745
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5203-07
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316908908
—
WI
Enumeration date
07/26/2018
Last updated
07/26/2018
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