Individual
DARA HOLLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4024 CENTRAL AVE, ST PETERSBURG, FL 33711-1239
(727) 327-7656
(727) 388-1192
Mailing address
4024 CENTRAL AVE, ST PETERSBURG, FL 33711-1239
(727) 327-7656
(727) 388-1192
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW6192
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
761752600
—
FL
01
—
EY507Z
MEDICARE
FL
01
—
F00545
FLORIDA HEALTH PARTNERS
FL
Enumeration date
07/19/2006
Last updated
04/22/2014
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