Jacqueline Kay Holgate, OTR/L

Individual provider Active NPI Occupational Therapist · Elk Point, SD

NPI 1104236116 · NPPES record last updated Apr 29, 2014

Key facts

NPI
1104236116
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
0916 (SD)
Practice address
600 S Franklin St
Elk Point, SD 57025
Phone
(605) 356-3894
NPI assigned
Apr 29, 2014
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1798NEMDPhysical Therapy Assistant
0916SDMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 0916 SD Yes
Occupational Therapist 225X00000X 002428 IA
Occupational Therapist 225X00000X 1798 NE

Addresses

Primary practice location

600 S Franklin St
Elk Point, SD 57025

Mailing address

1705 Country Club Dr
Elk Point, SD 57025-2325
Phone (507) 848-0436

Other providers in Elk Point, SD

All providers in Elk Point, SD · Occupational Therapist in South Dakota

Sources for this page

Verify at the official NPI Registry.