Individual
MS. SALLY JO HOLLOWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2070 TEMPLE AVE, MERRITT ISLAND, FL 32953-4221
(321) 453-8976
(321) 453-8976
Mailing address
2070 TEMPLE AVE, MERRITT ISLAND, FL 32953-4221
(321) 453-8976
(321) 453-8976
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
676830096
—
FL
05
—
676830098
—
FL
Enumeration date
11/28/2005
Last updated
03/30/2011
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