Provider Demographics
NPI:1184040438
Name:DAVIS, HOLLIE PATRICE (OTR/L)
Entity Type:Individual
Prefix:
First Name:HOLLIE
Middle Name:PATRICE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5054 THOROUGHBRED LN
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4225
Mailing Address - Country:US
Mailing Address - Phone:615-376-7876
Mailing Address - Fax:615-376-7866
Practice Address - Street 1:5054 THOROUGHBRED LN
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-4225
Practice Address - Country:US
Practice Address - Phone:615-376-7876
Practice Address - Fax:615-376-7866
Is Sole Proprietor?:No
Enumeration Date:2014-03-11
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4916225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist