Provider Demographics
NPI:1336710516
Name:HOLT, MAGGIE CLAIRE (COTA/L)
Entity Type:Individual
Prefix:
First Name:MAGGIE
Middle Name:CLAIRE
Last Name:HOLT
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 1:803 2ND ST # B
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38464-2926
Mailing Address - Country:US
Mailing Address - Phone:931-231-9303
Mailing Address - Fax:
Practice Address - Street 1:1311 S LOCUST AVE STE 101
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:TN
Practice Address - Zip Code:38464-4054
Practice Address - Country:US
Practice Address - Phone:931-766-6374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOTA0000003471224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant