MEDICARE: MARCI LYNN HOLLOWAY LCSW

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	1041C0700X	Clinical Social Worker	29938	TX

General Provider Information

NPI Number	:	1245436435
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCI LYNN HOLLOWAY LCSW

Provider Business Mailing Address
First Line	:	909 LEDGEMONT DR
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75025-3508
Country	:	US
Telephone Number	:	817-233-7269
Fax Number	:

Provider Business Practice Location Address
First Line	:	6404 INTERNATIONAL PKWY
Second Line	:	SUITE 2100
City	:	PLANO
State	:	TX
Zip	:	75093-8225
Country	:	US
Telephone Number	:	817-233-7269
Fax Number	:

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

Provider Enumeration Date	:	06/25/2007
Last Update Date	:	09/21/2007

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