Provider Demographics
NPI:1144738063
Name:HOLLINGSWORTH, TAMARA KING (MSW)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:KING
Last Name:HOLLINGSWORTH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 BEN BURTON CIR STE 100
Mailing Address - Street 2:
Mailing Address - City:BOGART
Mailing Address - State:GA
Mailing Address - Zip Code:30622-6802
Mailing Address - Country:US
Mailing Address - Phone:706-329-0077
Mailing Address - Fax:
Practice Address - Street 1:3565 PEACH ORCHARD RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30906-8938
Practice Address - Country:US
Practice Address - Phone:706-329-0077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-12
Last Update Date:2018-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker