Provider Demographics
NPI:1467795153
Name:HOLMAN, KENSEY MCKAY (OTR/L)
Entity Type:Individual
Prefix:
First Name:KENSEY
Middle Name:MCKAY
Last Name:HOLMAN
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 1:903 E MONROE AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74501-4839
Mailing Address - Country:US
Mailing Address - Phone:918-421-6800
Mailing Address - Fax:918-421-8686
Practice Address - Street 1:903 E MONROE AVE STE 200
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501
Practice Address - Country:US
Practice Address - Phone:918-421-6800
Practice Address - Fax:918-421-8686
Is Sole Proprietor?:No
Enumeration Date:2013-04-01
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1800225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist