Provider Demographics
NPI:1255873287
Name:HOLMES, CAMERON (OTR/L)
Entity type:Individual
Prefix:MR
First Name:CAMERON
Middle Name:
Last Name:HOLMES
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13450 CEDAR RD APT 27
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-2961
Mailing Address - Country:US
Mailing Address - Phone:517-416-0212
Mailing Address - Fax:
Practice Address - Street 1:14900 PRIVATE DR
Practice Address - Street 2:
Practice Address - City:EAST CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44112-3470
Practice Address - Country:US
Practice Address - Phone:216-851-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-08
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT009575225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist