Healthcare Provider Details

I. General information

NPI: 1962872309
Provider Name (Legal Business Name): HOLLY ESKEW LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2015
Last Update Date: 09/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2805 SHINGO CT
COLUMBIA MO
65202-4222
US

IV. Provider business mailing address

2805 SHINGO CT
COLUMBIA MO
65202-4222
US

V. Phone/Fax

Practice location:
  • Phone: 573-825-4180
  • Fax:
Mailing address:
  • Phone: 573-825-4180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2014042639
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: