Provider Demographics
NPI:1568943710
Name:LOVITT, HOLLY ANN (COTA)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:ANN
Last Name:LOVITT
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:ANN
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1409 COUNTY ROAD 807
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76031-0307
Mailing Address - Country:US
Mailing Address - Phone:682-260-0041
Mailing Address - Fax:
Practice Address - Street 1:206 WALLS DR
Practice Address - Street 2:
Practice Address - City:CLEBURNE
Practice Address - State:TX
Practice Address - Zip Code:76033-4045
Practice Address - Country:US
Practice Address - Phone:817-645-0668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-26
Last Update Date:2018-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX215241224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant