MEDICARE: HOLLY H HADLEY PSY.D.

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	103TC0700X	Clinical Psychologist	1045	SC

General Provider Information

NPI Number	:	1700904760
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOLLY H HADLEY PSY.D.

Provider Business Mailing Address
First Line	:	6650 RIVERS AVE
Second Line	:
City	:	N CHARLESTON
State	:	SC
Zip	:	29406-4809
Country	:	US
Telephone Number	:	843-278-5221
Fax Number	:	877-417-5177

Provider Business Practice Location Address
First Line	:	6650 RIVERS AVE
Second Line	:
City	:	N CHARLESTON
State	:	SC
Zip	:	29406-4809
Country	:	US
Telephone Number	:	843-278-5221
Fax Number	:	877-417-5177

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

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	09/25/2023

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