Individual
BOBBIE LAYNE HOLLOWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12 RIVERGATE DR, POQUOSON, VA 23662-1312
(757) 876-8616
Mailing address
12 RIVERGATE DR, POQUOSON, VA 23662-1312
(757) 876-8616
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-175957
VA
Other
Enumeration date
07/16/2021
Last updated
07/16/2021
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