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Individual

MRS. PAULA VANESSA HOLLOWAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MED LMFT

Contact information

Practice address
109 WEST WATAUGA AVENUE, JOHNSON CITY, TN 37604
(423) 232-2700
Mailing address
PO BOX 9054, GRAY, TN 37615-9054
(423) 467-3600
(423) 467-3696

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LMT238
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3085403
MAGELLAN SUMMIT
01
334969
VALUE OPTIONS GROUP
01
62058260566
UBH JOHN DEERE
Enumeration date
09/12/2006
Last updated
07/08/2007
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