Provider Demographics
NPI:1710706650
Name:LINN, HOLLY (COTA)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:LINN
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 1:5253 N COUNTY ROAD 975 W
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:IN
Mailing Address - Zip Code:47264-9320
Mailing Address - Country:US
Mailing Address - Phone:812-521-4115
Mailing Address - Fax:
Practice Address - Street 1:2100 25TH ST STE K
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-3203
Practice Address - Country:US
Practice Address - Phone:812-372-3035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-08
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant