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Individual

KECHIA J HOLLOWAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
11700 N 58TH ST STE D, TEMPLE TERRACE, FL 33617-1692
(813) 605-5555
Mailing address
11700 N 58TH ST STE D, TEMPLE TERRACE, FL 33617-1692
(813) 605-5555

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
251S00000X
Community/Behavioral Health Agency
Primary
CBHCMS100302
FL

Other

Enumeration date
10/25/2011
Last updated
02/11/2022
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