Provider Demographics
NPI:1679162234
Name:HOLLIDAY, KATHERINE MONTANA
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MONTANA
Last Name:HOLLIDAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 NEVINS LN
Mailing Address - Street 2:
Mailing Address - City:WEST HARWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02671-1007
Mailing Address - Country:US
Mailing Address - Phone:413-427-6230
Mailing Address - Fax:
Practice Address - Street 1:263 ALDEN ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01109-3788
Practice Address - Country:US
Practice Address - Phone:413-427-6230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-18
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer