Provider Demographics
NPI:1083161228
Name:HOLTSLANDER CAMP, TAMMI
Entity Type:Individual
Prefix:
First Name:TAMMI
Middle Name:
Last Name:HOLTSLANDER CAMP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TAMMI
Other - Middle Name:
Other - Last Name:HOLTSLANDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:24 CHERRY ST
Mailing Address - Street 2:OT PT DEPARTMENT
Mailing Address - City:JOHNSON CITY
Mailing Address - State:NY
Mailing Address - Zip Code:13790-2615
Mailing Address - Country:US
Mailing Address - Phone:607-723-8313
Mailing Address - Fax:
Practice Address - Street 1:24 CHERRY ST
Practice Address - Street 2:OT PT DEPARTMENT
Practice Address - City:JOHNSON CITY
Practice Address - State:NY
Practice Address - Zip Code:13790-2615
Practice Address - Country:US
Practice Address - Phone:607-723-8313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-06
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY63020799225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist