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General NPI Number Information
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NPI Number | 1104210905
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Entity Type | Individual
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Provider Name | DONNETTE NICOLE HOLLOWAY LMSW
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Gender | Female
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Dates
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Enumeration Date | 03/19/2015
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Last Update Date | 03/19/2015
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Provider Practice Location Address
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Address Line | 7940 PARALLEL PKWY STE 1
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City | KANSAS CITY
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State | KS
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Zip | 66112-2070
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Country | US
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Telephone | 913-908-6986
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Fax |
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Provider Business Mailing Address
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Address Line | 7618 W 59TH TER APT 314
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City | OVERLAND PARK
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State | KS
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Zip | 66202-4417
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Country | US
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Telephone | 702-327-9789
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 8275
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License Number State | KS
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