Holly Broach, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

008756 Issued in OH

Practice address

580 Lincoln Park Blvd
Kettering, OH 45429-3474

Phone

(937) 499-1400

NPI assigned

Mar 31, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1396224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578528000000",
    "number": "1992123608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5433 RED COACH RD",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454296113",
            "telephone_number": "937-838-2366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 LINCOLN PARK BLVD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454293474",
            "telephone_number": "937-499-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROACH",
        "first_name": "HOLLY",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-31",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "008756",
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OH",
            "license": "OTA 02967",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Elizabeth Breeding, PT, DPT
• William R. Breeding, M.D.
• Robert Kirk Brenneman
• Lucas Brewer, LPCC-S
• Janet Lee Breyer, LPCC S
• Kenneth W Brock, MD
• Tiffani Brock
• Loren Brockert, LMT NCTMB
• Derek Lee Broering, MD
• Pam Lynn Brokaw-Myers, NP

• Occupational Therapist in Kettering, OH
• Providers in Kettering, OH by specialty
• Occupational Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.