MEDICARE: HOLLEY MARIE WOOD

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	171400000X	Health & Wellness Coach

General Provider Information

NPI Number	:	1922800507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOLLEY MARIE WOOD

Provider Business Mailing Address
First Line	:	70 W MAIN ST STE 301
Second Line	:
City	:	NEW BRITAIN
State	:	CT
Zip	:	06051-4224
Country	:	US
Telephone Number	:	860-960-3530
Fax Number	:

Provider Business Practice Location Address
First Line	:	70 W MAIN ST STE 301
Second Line	:
City	:	NEW BRITAIN
State	:	CT
Zip	:	06051-4224
Country	:	US
Telephone Number	:	860-960-3530
Fax Number	:

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

Provider Enumeration Date	:	03/25/2025
Last Update Date	:	03/25/2025

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Directions to “ HOLLEY MARIE WOOD ” Practice Location

Language	Start Address	Practice Location

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