MEDICARE: HOLLY JEAN MAY MA

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	101YM0800X	Mental Health Counselor	6436	SC

General Provider Information

NPI Number	:	1376618264
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOLLY JEAN MAY MA

Provider Business Mailing Address
First Line	:	3139 SIDNEY RD
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29210-4430
Country	:	US
Telephone Number	:	803-798-2574
Fax Number	:	803-898-2194

Provider Business Practice Location Address
First Line	:	ALL OVER THE STATE
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29202
Country	:	US
Telephone Number	:	803-898-2025
Fax Number	:	803-898-2184

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

Provider Enumeration Date	:	11/24/2006
Last Update Date	:	11/20/2024

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Directions to “ HOLLY JEAN MAY MA” Practice Location

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