MEDICARE: DR. DOROTHY ESTELLA ADAMSON HOLLEY PH.D., LCSW-C

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
1	1041C0700X	Clinical Social Worker	07458	MD

General Provider Information

NPI Number	:	1285791335
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DOROTHY ESTELLA ADAMSON HOLLEY PH.D., LCSW-C

Provider Business Mailing Address
First Line	:	2818 EVERGREEN AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21214-1735
Country	:	US
Telephone Number	:	410-444-6824
Fax Number	:	410-444-6824

Provider Business Practice Location Address
First Line	:	2818 EVERGREEN AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21214-1735
Country	:	US
Telephone Number	:	410-444-6824
Fax Number	:	410-444-6824

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/01/2007
Last Update Date	:	07/09/2007

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