Provider Demographics
NPI:1518385996
Name:BATEMAN, HOLLY (LOTR, MS)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:
Last Name:BATEMAN
Suffix:
Gender:F
Credentials:LOTR, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10514 STRINGER BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SAINT AMANT
Mailing Address - State:LA
Mailing Address - Zip Code:70774-4217
Mailing Address - Country:US
Mailing Address - Phone:225-571-0131
Mailing Address - Fax:225-675-6806
Practice Address - Street 1:10514 STRINGER BRIDGE RD
Practice Address - Street 2:
Practice Address - City:SAINT AMANT
Practice Address - State:LA
Practice Address - Zip Code:70774-4217
Practice Address - Country:US
Practice Address - Phone:225-571-0131
Practice Address - Fax:225-675-6806
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-02
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAOTT.Z11893225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAOTT.Z11893OtherLOUISIANA STATE BOARD OF MEDICAL EXAMINERS