Provider Demographics
NPI:1770151094
Name:HOLLINGSWORTH, CAROL (OTR/L)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:HOLLINGSWORTH
Suffix:
Gender:F
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 1:6023 KENILWORTH DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76001-5211
Mailing Address - Country:US
Mailing Address - Phone:949-378-7358
Mailing Address - Fax:
Practice Address - Street 1:6023 KENILWORTH DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76001-5211
Practice Address - Country:US
Practice Address - Phone:949-378-7358
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-14
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX121497225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist