Provider Demographics
NPI:1083080212
Name:HOLLOWAY, ASHLEY CHARNE (MS)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:CHARNE
Last Name:HOLLOWAY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MRS
Other - First Name:ASHLEY
Other - Middle Name:CHARNE
Other - Last Name:HOLLOWAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:522 ARROW ST
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32404-6801
Mailing Address - Country:US
Mailing Address - Phone:850-625-8428
Mailing Address - Fax:
Practice Address - Street 1:2711 W 15TH ST
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-1366
Practice Address - Country:US
Practice Address - Phone:850-769-6001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-11
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health