Provider Demographics
NPI:1629746839
Name:BRYANT, HOLLYANN KATHERINE (COTA/L)
Entity Type:Individual
Prefix:MISS
First Name:HOLLYANN
Middle Name:KATHERINE
Last Name:BRYANT
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 GRAND ISLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:14072-2249
Mailing Address - Country:US
Mailing Address - Phone:716-773-4323
Mailing Address - Fax:
Practice Address - Street 1:1 NAGEL DR
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-3818
Practice Address - Country:US
Practice Address - Phone:716-631-7471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010772224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant