Provider Demographics
NPI:1083347546
Name:HOLLOWAY, MELBA DAVIS (EDS)
Entity Type:Individual
Prefix:
First Name:MELBA
Middle Name:DAVIS
Last Name:HOLLOWAY
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 1ST ST N STE 250
Mailing Address - Street 2:
Mailing Address - City:ALABASTER
Mailing Address - State:AL
Mailing Address - Zip Code:35007-9071
Mailing Address - Country:US
Mailing Address - Phone:205-624-2422
Mailing Address - Fax:205-624-3091
Practice Address - Street 1:224 1ST ST N STE 250
Practice Address - Street 2:
Practice Address - City:ALABASTER
Practice Address - State:AL
Practice Address - Zip Code:35007-9071
Practice Address - Country:US
Practice Address - Phone:205-624-2422
Practice Address - Fax:205-624-3091
Is Sole Proprietor?:No
Enumeration Date:2022-07-02
Last Update Date:2022-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health