Provider Demographics
NPI:1154532182
Name:HOLLWEDEL, KAREN (OTR)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:
Last Name:HOLLWEDEL
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 1:1610 MORNING DOVE LOOP N
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33809-7700
Mailing Address - Country:US
Mailing Address - Phone:863-255-6603
Mailing Address - Fax:
Practice Address - Street 1:3133 LAKELAND HILLS BLVD
Practice Address - Street 2:SUITE 1 & 2
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-2208
Practice Address - Country:US
Practice Address - Phone:863-603-0515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 9926225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist