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Individual

LARRY BERNARD HOLLOWAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PROBATION OFFICER 2

Contact information

Practice address
12310 LOWER AZUSA RD, ARCADIA, CA 91006-5872
(626) 579-8593
(626) 433-1029
Mailing address
12310 LOWER AZUSA RD, ARCADIA, CA 91006-5872
(626) 579-8506
(626) 433-1029

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
171M00000X
PROBATION
CA
01
876543100
PROBATION
CA
Enumeration date
06/23/2011
Last updated
06/23/2011
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