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General NPI Number Information
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NPI Number | 1609528934
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Entity Type | Individual
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Provider Name | SHEMEKA HOLLIS
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Gender | Female
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Dates
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Enumeration Date | 01/18/2022
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Last Update Date | 01/18/2022
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Provider Practice Location Address
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Address Line | 839 QUINCE ORCHARD BLVD
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City | GAITHERSBURG
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State | MD
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Zip | 20878-1614
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Country | US
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Telephone | 240-903-5708
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Fax |
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Provider Business Mailing Address
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Address Line | 4112 CLARK ST
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City | CAPITOL HEIGHTS
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State | MD
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Zip | 20743-5742
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Country | US
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Telephone | 240-882-1173
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LGP12229
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License Number State | MD
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