Provider Demographics
NPI:1649637620
Name:MANN, HOLLY (COTA)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:MANN
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 CYNTHIA DR
Mailing Address - Street 2:
Mailing Address - City:COVENTRY
Mailing Address - State:RI
Mailing Address - Zip Code:02816-8412
Mailing Address - Country:US
Mailing Address - Phone:401-480-8157
Mailing Address - Fax:
Practice Address - Street 1:6 CYNTHIA DR
Practice Address - Street 2:
Practice Address - City:COVENTRY
Practice Address - State:RI
Practice Address - Zip Code:02816-8412
Practice Address - Country:US
Practice Address - Phone:401-480-8157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-21
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant