Individual
MRS. THERESA ANN HOLGERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
600 S BROAD ST, KENNETT SQUARE, PA 19348-3346
(610) 925-4563
Mailing address
600 S BROAD ST, KENNETT SQUARE, PA 19348-3346
(610) 925-4563
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
OP000644L
PA
Other
Enumeration date
04/22/2013
Last updated
04/22/2013
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