Provider Demographics
NPI:1982707006
Name:HOLLEY, YOLANDA CHARMAINE (OTR)
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:CHARMAINE
Last Name:HOLLEY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1634 FAR DR
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-1673
Mailing Address - Country:US
Mailing Address - Phone:901-550-1548
Mailing Address - Fax:901-820-4336
Practice Address - Street 1:5865 RIDGEWAY CENTER PKWY
Practice Address - Street 2:SUITE 300
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-4032
Practice Address - Country:US
Practice Address - Phone:901-820-4335
Practice Address - Fax:901-820-4336
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist