Provider Demographics
NPI:1316646920
Name:HOLLOWAY, HALEY FAITH (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:FAITH
Last Name:HOLLOWAY
Suffix:
Gender:
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:HALEY
Other - Middle Name:FAITH
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTD, OTR/L
Mailing Address - Street 1:400 GRAND CT
Mailing Address - Street 2:
Mailing Address - City:SILOAM SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72761-3113
Mailing Address - Country:US
Mailing Address - Phone:918-899-0662
Mailing Address - Fax:
Practice Address - Street 1:5230 WILLOW CREEK DR STE 101
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-0898
Practice Address - Country:US
Practice Address - Phone:479-445-6800
Practice Address - Fax:479-445-6816
Is Sole Proprietor?:No
Enumeration Date:2023-03-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR3771225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AROTR3771OtherOT LICENSE FOR AR
487607OtherNBCOT CERTIFICATION NUMBER