Provider Demographics
NPI:1659902559
Name:HOLLOWAY, KENDALL BRIANNE (MSED)
Entity Type:Individual
Prefix:
First Name:KENDALL
Middle Name:BRIANNE
Last Name:HOLLOWAY
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 ARDEN CREEK CT APT 3301
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-5646
Mailing Address - Country:US
Mailing Address - Phone:804-432-5917
Mailing Address - Fax:
Practice Address - Street 1:709 W MAIN ST # A
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-4570
Practice Address - Country:US
Practice Address - Phone:434-326-4577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-29
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health