Individual
CLARISSA HOLLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2210 FILLMORE ST, WICHITA FALLS, TX 76309-4310
(940) 730-5447
Mailing address
2210 FILLMORE ST, WICHITA FALLS, TX 76309-4310
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
M01881195
—
TX
Enumeration date
01/11/2019
Last updated
01/11/2019
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