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Individual

DR. MARY LOU HOLLIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ED.D.

Contact information

Practice address
5464 HOLIDAY TER, KALAMAZOO, MI 49009-2147
(269) 372-1940
(269) 349-5105
Mailing address
5464 HOLIDAY TER, KALAMAZOO, MI 49009-2147
(269) 372-1940
(269) 349-5105

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
6301002452
MI
106H00000X
Marriage & Family Therapist
Primary
4101005257
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
007039
VALUEOPTIONS
MI
01
OC945940
BCBSM
MI
Enumeration date
07/03/2005
Last updated
09/11/2025
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