Individual
MARK LEONARD HOLLOWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LLPC
Contact information
Practice address
1675 BALDWIN ST, JENISON, MI 49428-8912
(616) 426-9034
Mailing address
1675 BALDWIN ST, JENISON, MI 49428-8912
(616) 426-9034
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401016504
MI
Other
Enumeration date
03/23/2018
Last updated
04/08/2020
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