Provider Demographics
NPI:1750857603
Name:HOLLOMAN, TORRIE (MS)
Entity Type:Individual
Prefix:MS
First Name:TORRIE
Middle Name:
Last Name:HOLLOMAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 W 46TH ST FL 2
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-4002
Mailing Address - Country:US
Mailing Address - Phone:201-993-6610
Mailing Address - Fax:
Practice Address - Street 1:43 W 46TH ST FL 2
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-4002
Practice Address - Country:US
Practice Address - Phone:201-993-6610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-18
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ$$$$$$$$$Medicaid