Provider Demographics
NPI:1043501893
Name:HOLTERMAN, DENISE L (OT)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:L
Last Name:HOLTERMAN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MRS
Other - First Name:DENISE
Other - Middle Name:L
Other - Last Name:BORCHARDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:27334 FOXHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:WIND LAKE
Mailing Address - State:WI
Mailing Address - Zip Code:53185-1978
Mailing Address - Country:US
Mailing Address - Phone:262-895-2207
Mailing Address - Fax:
Practice Address - Street 1:27334 FOXHAVEN DR
Practice Address - Street 2:
Practice Address - City:WIND LAKE
Practice Address - State:WI
Practice Address - Zip Code:53185-1978
Practice Address - Country:US
Practice Address - Phone:262-895-2207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-27
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility