MEDICARE: MRS. HOLLY B BARRUSO MA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3376955	OTHER	TN	GROUP MEDICARE

General Provider Information

NPI Number	:	1184892994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HOLLY B BARRUSO MA

Provider Business Mailing Address
First Line	:	3071 ROMAIN TRL
Second Line	:
City	:	SPRING HILL
State	:	TN
Zip	:	37174-6176
Country	:	US
Telephone Number	:	615-618-2080
Fax Number	:

Provider Business Practice Location Address
First Line	:	3071 ROMAIN TRL
Second Line	:
City	:	SPRING HILL
State	:	TN
Zip	:	37174-6176
Country	:	US
Telephone Number	:	615-618-2080
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2008
Last Update Date	:	05/03/2013

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