Provider Demographics
NPI:1093256489
Name:HOLLINS, MARY C (MA, CDCA)
Entity Type:Individual
Prefix:MISS
First Name:MARY
Middle Name:C
Last Name:HOLLINS
Suffix:
Gender:F
Credentials:MA, CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4401 ROCKSIDE RD STE 401
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44131-2147
Mailing Address - Country:US
Mailing Address - Phone:239-009-0473
Mailing Address - Fax:
Practice Address - Street 1:4401 ROCKSIDE RD STE 401
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:OH
Practice Address - Zip Code:44131-2147
Practice Address - Country:US
Practice Address - Phone:239-009-0473
Practice Address - Fax:216-432-7259
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-17
Last Update Date:2022-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator