Provider Demographics
NPI:1326083080
Name:JAVIER, HOLLY H (MPT)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:H
Last Name:JAVIER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2731 NAPOLEON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-6913
Mailing Address - Country:US
Mailing Address - Phone:504-897-6351
Mailing Address - Fax:504-899-7317
Practice Address - Street 1:2731 NAPOLEON AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-6913
Practice Address - Country:US
Practice Address - Phone:504-897-6351
Practice Address - Fax:504-899-7317
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA03253174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist