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General NPI Number Information
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NPI Number | 1891949145
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Entity Type | Organization
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Legal Business Name | KIDADA HOLLOWAY
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Dates
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Enumeration Date | 11/13/2008
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Last Update Date | 11/13/2008
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Provider Practice Location Address
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Address Line | 415 CHUNNS COVE RD APT 200B
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City | ASHEVILLE
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State | NC
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Zip | 28805-1035
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Country | US
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Telephone | 828-582-1688
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Fax |
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Provider Business Mailing Address
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Address Line | 415 CHUNNS COVE RD APT 200B
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City | ASHEVILLE
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State | NC
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Zip | 28805-1035
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Country | US
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Telephone | 828-582-1688
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | MS. KIDADA HOLLOWAY
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Credential | LPC
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Telephone | 828-582-1688
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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 | 6585
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License Number State | NC
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