Provider Demographics
NPI:1710783014
Name:SCARBOROUGH, HOLLY (OTR)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:SCARBOROUGH
Suffix:
Gender:
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 HEATHER LANE
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:TX
Mailing Address - Zip Code:77657
Mailing Address - Country:US
Mailing Address - Phone:409-673-3545
Mailing Address - Fax:
Practice Address - Street 1:810 S MASON RD STE 101
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-3857
Practice Address - Country:US
Practice Address - Phone:281-392-7811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX121355225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist