Provider Demographics
NPI:1619166303
Name:HOLLOWAY, DEBRA (MA, LMHC)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:
Last Name:HOLLOWAY
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 AYER RD
Mailing Address - Street 2:
Mailing Address - City:HARVARD
Mailing Address - State:MA
Mailing Address - Zip Code:01451-1131
Mailing Address - Country:US
Mailing Address - Phone:978-660-6825
Mailing Address - Fax:
Practice Address - Street 1:233 AYER RD
Practice Address - Street 2:
Practice Address - City:HARVARD
Practice Address - State:MA
Practice Address - Zip Code:01451-1131
Practice Address - Country:US
Practice Address - Phone:978-772-3070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-18
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6557101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health