Healthcare Provider Details

I. General information

NPI: 1760312920
Provider Name (Legal Business Name): HOLLY SCARBROUGH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 E 1ST ST
PROSPER TX
75078-2919
US

IV. Provider business mailing address

805 E 1ST ST
PROSPER TX
75078-2919
US

V. Phone/Fax

Practice location:
  • Phone: 469-481-6965
  • Fax:
Mailing address:
  • Phone: 469-481-6965
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number102405
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: