Individual
DR. ALLAN RAY HOLLIS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1201 BISHOP ST, UNION CITY, TN 38261-5403
(731) 884-8203
(731) 884-8564
Mailing address
191 FIELDWOOD DR, HUNTINGDON, TN 38344-1801
(731) 986-8532
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
P-0000001282
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3282942
MEDICARE GP/ORGN PTAN
—
01
—
36863201
MEDICARE INDIVIDUAL PTAN
—
01
—
4136107
BCBS
TN
Enumeration date
10/13/2006
Last updated
10/09/2007
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