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NPI Code Detail

MEDICARE: MRS. HOLLY MARIE MACKIN MA, LMFTA

MEDICARE: MRS. HOLLY MARIE MACKIN MA, LMFTA
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
1106H00000XMarriage & Family Therapist7046ANC

General Provider Information

NPI Number : 1326347881
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. HOLLY MARIE MACKIN MA, LMFTA
Provider Business Mailing Address
First Line : 301 HILLCREST DR
Second Line :
City : BELMONT
State : NC
Zip : 28012-2310
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 133 W CATAWBA AVE
Second Line :
City : MT HOLLY
State : NC
Zip : 28120-1601
Country : US
Telephone Number : 704-827-9922
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2011
Last Update Date : 03/23/2011

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