Provider Demographics
NPI:1811349723
Name:HOLZER, KAYLEIGH (MOT, OTR/L)
Entity type:Individual
Prefix:
First Name:KAYLEIGH
Middle Name:
Last Name:HOLZER
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:KAYLEIGH
Other - Middle Name:
Other - Last Name:WOLFHOPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MOT, OTR/L
Mailing Address - Street 1:14901 BOGLE DR
Mailing Address - Street 2:
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20151-1735
Mailing Address - Country:US
Mailing Address - Phone:540-720-2261
Mailing Address - Fax:
Practice Address - Street 1:14901 BOGLE DR
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-1735
Practice Address - Country:US
Practice Address - Phone:540-720-2261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-05
Last Update Date:2023-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119007018225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist