Holly Davis Baker, COTA

Individual provider Active NPI Occupational Therapy Assistant · Thayer, MO

NPI 1659888451 · NPPES record last updated Jan 3, 2018

Key facts

NPI
1659888451
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
2017003081 (MO)
Practice address
709 Hwy 19
Thayer, MO 65791
Phone
(417) 264-7256
NPI assigned
Jan 3, 2018
Sex
Female
Sole proprietor
Yes

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
2017003081MOMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 2017003081 MO Yes

Addresses

Primary practice location

709 Hwy 19
Thayer, MO 65791

Mailing address

709 Hwy 19
Thayer, MO 65791
Phone (417) 264-7256

Other providers in Thayer, MO

All providers in Thayer, MO · Occupational Therapy Assistant in Missouri

Sources for this page

Verify at the official NPI Registry.