Provider Demographics
NPI:1073867479
Name:HOLLADAY, DAWN (MS)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:HOLLADAY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 LEATHERS RD
Mailing Address - Street 2:
Mailing Address - City:FORT MITCHELL
Mailing Address - State:KY
Mailing Address - Zip Code:41017-2908
Mailing Address - Country:US
Mailing Address - Phone:859-301-5396
Mailing Address - Fax:
Practice Address - Street 1:20 MEDICAL VILLAGE DR STE 212
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:KY
Practice Address - Zip Code:41017-5405
Practice Address - Country:US
Practice Address - Phone:859-301-5396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-07
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS