Individual
HOLLY LOUISE HANSON X
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
195 MATTIE M KELLY BLVD, DESTIN, FL 32541-2811
(850) 654-4588
Mailing address
15 E BRADLEY ST LOT 3, MIRAMAR BEACH, FL 32550-6870
(850) 502-3008
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT17626
FL
Other
Enumeration date
07/04/2019
Last updated
07/04/2019
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