Provider Demographics
NPI:1154501542
Name:HOLTZMAN, NIKI ANN (MS OTR/L)
Entity Type:Individual
Prefix:MS
First Name:NIKI
Middle Name:ANN
Last Name:HOLTZMAN
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 ELM ST
Mailing Address - Street 2:
Mailing Address - City:AYER
Mailing Address - State:MA
Mailing Address - Zip Code:01432-1609
Mailing Address - Country:US
Mailing Address - Phone:978-772-3475
Mailing Address - Fax:
Practice Address - Street 1:5 ELM ST
Practice Address - Street 2:
Practice Address - City:AYER
Practice Address - State:MA
Practice Address - Zip Code:01432-1609
Practice Address - Country:US
Practice Address - Phone:978-772-3475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAOT-513172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker