MEDICARE: CANDICE HOLLOWAY

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	101YP2500X	Professional Counselor	73866	TX

General Provider Information

NPI Number	:	1285293654
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CANDICE HOLLOWAY

Provider Business Mailing Address
First Line	:	2010 NORTH LOOP W STE 240
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77018-8125
Country	:	US
Telephone Number	:	281-626-0505
Fax Number	:

Provider Business Practice Location Address
First Line	:	2010 NORTH LOOP W STE 240
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77018-8125
Country	:	US
Telephone Number	:	281-626-0505
Fax Number	:

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

Provider Enumeration Date	:	06/10/2019
Last Update Date	:	04/25/2025

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Directions to “ CANDICE HOLLOWAY ” Practice Location

Language	Start Address	Practice Location

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