Basic Information
| Provider Information | |||||||||
| NPI: | 1255092490 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BARRETT | ||||||||
| FirstName: | HOLLY | ||||||||
| MiddleName: | MONIKA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5840 RED BUG LAKE RD STE 375 | ||||||||
| Address2: | |||||||||
| City: | WINTER SPGS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327085011 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3219615058 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7457 ALOMA AVE STE 201 | ||||||||
| Address2: | |||||||||
| City: | WINTER PARK | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327929172 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3214451287 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/09/2022 | ||||||||
| LastUpdateDate: | 01/09/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 224ZR0403X | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Driving and Community Mobility | 224Z00000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant |
No ID Information.