Provider Demographics
NPI:1356181788
Name:HOLOVE-MURILLO, MINELVA P (OTD)
Entity type:Individual
Prefix:DR
First Name:MINELVA
Middle Name:P
Last Name:HOLOVE-MURILLO
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 FOUNDRY RD
Mailing Address - Street 2:
Mailing Address - City:BLAIRSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07825-3409
Mailing Address - Country:US
Mailing Address - Phone:908-380-4076
Mailing Address - Fax:
Practice Address - Street 1:18 FOUNDRY RD
Practice Address - Street 2:
Practice Address - City:BLAIRSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07825-3409
Practice Address - Country:US
Practice Address - Phone:908-380-4076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-31
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR01144500225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist