MEDICARE: HOLLADAY CONSULTING, LLC

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1609553957
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLLADAY CONSULTING, LLC

Provider Business Mailing Address
First Line	:	517 E CAUSEWAY BLVD
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32963-2227
Country	:	US
Telephone Number	:	724-644-6126
Fax Number	:

Provider Business Practice Location Address
First Line	:	3150 CARDINAL DR
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32963-1931
Country	:	US
Telephone Number	:	727-644-6126
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ANDREA HOLLADAY
Credential	:
Telephone Number	:	727-644-6126

Provider Enumeration Date	:	06/29/2023
Last Update Date	:	06/29/2023

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