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NPI Code Detail

MEDICARE: ZACHARIAH ALLEN HOLLOWAY

MEDICARE: ZACHARIAH ALLEN HOLLOWAY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1RBT-20-145217OTHERRBT CREDENTIALS

General Provider Information

NPI Number : 1063086429
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZACHARIAH ALLEN HOLLOWAY
Provider Business Mailing Address
First Line : 6116 N WINTHROP AVE APT 2W
Second Line :
City : CHICAGO
State : IL
Zip : 60660-2637
Country : US
Telephone Number : 844-359-7629
Fax Number :
Provider Business Practice Location Address
First Line : 6116 N WINTHROP AVE APT 2W
Second Line :
City : CHICAGO
State : IL
Zip : 60660-2637
Country : US
Telephone Number : 844-359-7629
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2021
Last Update Date : 12/18/2025

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Directions to “ ZACHARIAH ALLEN HOLLOWAY ” Practice Location

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