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General NPI Number Information
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NPI Number | 1538028303
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Entity Type | Individual
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Provider Name | CORRIEL HOLLAWAY BCBA
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Gender | Female
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Dates
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Enumeration Date | 01/19/2026
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Last Update Date | 01/19/2026
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Provider Practice Location Address
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Address Line | 300 BROADACRES DR STE 175
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City | BLOOMFIELD
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State | NJ
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Zip | 07003-3165
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Country | US
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Telephone | 201-720-8600
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Fax |
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Provider Business Mailing Address
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Address Line | 39 BURNET ST FL 2
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City | NEWARK
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State | NJ
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Zip | 07102-2101
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Country | US
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Telephone | 908-487-4342
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-25-86863
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License Number State | NJ
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