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NPI Code Detail

MEDICARE: DR. RICHARD L HOLLOWAY PHD, LMFT

MEDICARE: DR. RICHARD L HOLLOWAY PHD, LMFT
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
1106H00000XMarriage & Family Therapist106WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1002000225DOTHERHUMANA

General Provider Information

NPI Number : 1215988043
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICHARD L HOLLOWAY PHD, LMFT
Provider Business Mailing Address
First Line : 1000 N 92ND ST
Second Line : CLINICS AT CURATIVE
City : MILWAUKEE
State : WI
Zip : 53226-3533
Country : US
Telephone Number : 414-456-8696
Fax Number : 414-456-6523
Provider Business Practice Location Address
First Line : 1000 N 92ND ST
Second Line : CLINICS AT CURATIVE
City : MILWAUKEE
State : WI
Zip : 53226-3533
Country : US
Telephone Number : 414-456-8696
Fax Number : 414-456-6523
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2006
Last Update Date : 02/14/2013

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