Provider Demographics
NPI:1588846075
Name:HOLLEY, GINGER LEIGH (MA, OTR/L)
Entity Type:Individual
Prefix:MS
First Name:GINGER
Middle Name:LEIGH
Last Name:HOLLEY
Suffix:
Gender:F
Credentials:MA, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1713 TELLICO DR
Mailing Address - Street 2:
Mailing Address - City:THOMPSONS STATION
Mailing Address - State:TN
Mailing Address - Zip Code:37179-2307
Mailing Address - Country:US
Mailing Address - Phone:931-698-3420
Mailing Address - Fax:
Practice Address - Street 1:1713 TELLICO DR
Practice Address - Street 2:
Practice Address - City:THOMPSONS STATION
Practice Address - State:TN
Practice Address - Zip Code:37179-2307
Practice Address - Country:US
Practice Address - Phone:931-698-3420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-27
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000003755225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist