Provider Demographics
NPI:1134641681
Name:HOLLIER, HEATHER MARKS (LOTR)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:MARKS
Last Name:HOLLIER
Suffix:
Gender:F
Credentials:LOTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12307 LEGACY HILLS DR
Mailing Address - Street 2:
Mailing Address - City:GEISMAR
Mailing Address - State:LA
Mailing Address - Zip Code:70734-3164
Mailing Address - Country:US
Mailing Address - Phone:225-573-3806
Mailing Address - Fax:
Practice Address - Street 1:40497 BLACK BAYOU EXT STE A
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-6808
Practice Address - Country:US
Practice Address - Phone:225-644-0390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-16
Last Update Date:2017-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAOTT.200479225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist