Provider Demographics
NPI:1871113738
Name:COHOLAN, ALLISON MARIE (OTR/L)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:MARIE
Last Name:COHOLAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:526 MUSIC HALL WAY
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203-6750
Mailing Address - Country:US
Mailing Address - Phone:919-760-9718
Mailing Address - Fax:
Practice Address - Street 1:9200 GLENWATER DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-8557
Practice Address - Country:US
Practice Address - Phone:704-548-9345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-21
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12258225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist