Provider Demographics
NPI:1184128860
Name:HALLOWELL, CAMILA MARGARITA (MS, OTR/L)
Entity type:Individual
Prefix:MS
First Name:CAMILA
Middle Name:MARGARITA
Last Name:HALLOWELL
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10824 OLD MILL RD STE 10-1
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-2642
Mailing Address - Country:US
Mailing Address - Phone:402-680-1823
Mailing Address - Fax:402-991-3051
Practice Address - Street 1:10824 OLD MILL RD STE 10-1
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-2642
Practice Address - Country:US
Practice Address - Phone:402-680-1823
Practice Address - Fax:402-991-3051
Is Sole Proprietor?:No
Enumeration Date:2018-03-19
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2178225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE2178OtherLICENSE