Individual
HOLLY MARIETTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDCA
Contact information
Practice address
48 PRIVATE DRIVE 339, SOUTH POINT, OH 45680-8919
(740) 451-1455
Mailing address
48 PRIVATE DRIVE 339, SOUTH POINT, OH 45680-8919
(740) 451-1455
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.165086
OH
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
11/15/2017
Last updated
04/10/2018
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