Individual
DR. BRADFORD OWEN HOLLOWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
6701 HIGHWAY 67, BENTON, AR 72015
(501) 315-3344
Mailing address
PO BOX 1589, BENTON, AR 72018-1589
(501) 315-3344
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
802-C
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
55203
BLUECROSS BLUESHIELD
AR
Enumeration date
05/03/2006
Last updated
08/30/2018
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