Healthcare Provider Details

I. General information

NPI: 1730835943
Provider Name (Legal Business Name): EMILY HOLLOWAY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2022
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7355 LEWIS AVE STE B
TEMPERANCE MI
48182-1465
US

IV. Provider business mailing address

4459 S ADRIAN HWY
ADRIAN MI
49221-9760
US

V. Phone/Fax

Practice location:
  • Phone: 419-540-8469
  • Fax:
Mailing address:
  • Phone: 517-366-8685
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: