Provider Demographics
NPI:1033536842
Name:HOLT, MOLLY (MSOTR)
Entity Type:Individual
Prefix:MRS
First Name:MOLLY
Middle Name:
Last Name:HOLT
Suffix:
Gender:F
Credentials:MSOTR
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:
Other - Last Name:SABOL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4681 RAINMAKER ROW
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-7434
Mailing Address - Country:US
Mailing Address - Phone:812-701-4114
Mailing Address - Fax:
Practice Address - Street 1:2339 SOUTH SR 135
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143
Practice Address - Country:US
Practice Address - Phone:317-215-7228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-19
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31003925A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist