Provider Demographics
NPI:1689416109
Name:CRIST, HOLLY LEE (COTA)
Entity type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:LEE
Last Name:CRIST
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:115 EVERGREEN HILL DR
Mailing Address - Street 2:
Mailing Address - City:ETOWAH
Mailing Address - State:NC
Mailing Address - Zip Code:28729-7715
Mailing Address - Country:US
Mailing Address - Phone:320-282-3742
Mailing Address - Fax:
Practice Address - Street 1:41 COBBLERS WAY
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28804-1463
Practice Address - Country:US
Practice Address - Phone:828-575-0201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11632224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant