Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Holly Georgiana Moore, COTA/L

Individual provider Occupational Therapy Assistant · NPI 1396455754

Holly Georgiana Moore, COTA/L is an Occupational Therapy Assistant in Tifton, Georgia. Practices as a sole proprietor. Licensed in Georgia.

Licensed in
GA
In the registry since
2022
What do these letters mean?
COTA/L — Certified Occupational Therapy Assistant, Licensed
An occupational therapy assistant who is both certified and state licensed.

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Practice location Address checks out

1401 Tift Ave N Ste B
Tifton, GA 31794-3577
Phone: (229) 396-5644
Fax: (855) 565-1769
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapy Assistant (primary) Taxonomy 224Z00000X · Licence OTA002554 (GA)

Record details

NPI number1396455754
Entity typeIndividual (Type 1)
GenderFemale
Credentials COTA/L
Sole proprietorYes
NPI enumeratedNovember 28, 2022
Last updated in NPPESNovember 28, 2022
Certification dateNovember 28, 2022

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