Provider Demographics
NPI:1285116871
Name:HOLLIDAY, SARAH (COTA)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:HOLLIDAY
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:HOLLIDAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:COTA
Mailing Address - Street 1:3211 AMERSON DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-9495
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3211 AMERSON DR
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-9495
Practice Address - Country:US
Practice Address - Phone:713-898-2151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX208566208100000X, 224ZR0403X, 225XP0200X, 224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No224ZR0403XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantDriving and Community Mobility
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX208566OtherTBOT
TX208566OtherTX BOARD OF OCCUPATIONAL THERAPY EXAMINERS