Provider Demographics
NPI:1093919102
Name:HOLDEN, ERIN D (COTA)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:D
Last Name:HOLDEN
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:D
Other - Last Name:MCGHEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA
Mailing Address - Street 1:4343 N CLARENDON AVE
Mailing Address - Street 2:UNIT 1917
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-2698
Mailing Address - Country:US
Mailing Address - Phone:773-935-0239
Mailing Address - Fax:
Practice Address - Street 1:2710 N CLARK ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-1503
Practice Address - Country:US
Practice Address - Phone:773-348-3980
Practice Address - Fax:773-348-3980
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL057.002535224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant