Provider Demographics
NPI:1093395048
Name:HOLLEY, FAITH ROBISON (BCABA)
Entity Type:Individual
Prefix:
First Name:FAITH
Middle Name:ROBISON
Last Name:HOLLEY
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 STONE DR
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29625-2709
Mailing Address - Country:US
Mailing Address - Phone:864-247-6119
Mailing Address - Fax:
Practice Address - Street 1:136 STONE DR
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29625-2709
Practice Address - Country:US
Practice Address - Phone:864-247-6119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-13
Last Update Date:2022-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst