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General NPI Number Information
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NPI Number | 1396084711
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Entity Type | Individual
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Provider Name | MEREDITH LEA HOLLADAY LPC
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Gender | Female
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Dates
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Enumeration Date | 02/05/2013
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Last Update Date | 02/05/2013
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Provider Practice Location Address
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Address Line | 109 PINEYWOOD ST
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City | THOMASVILLE
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State | NC
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Zip | 27360-3434
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Country | US
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Telephone | 336-475-0852
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Fax |
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Provider Business Mailing Address
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Address Line | 1342 PINEBLUFF RD
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City | WINSTON SALEM
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State | NC
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Zip | 27103-4729
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Country | US
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Telephone | 336-848-1720
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6956
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License Number State | NC
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