Provider Demographics
NPI:1821446592
Name:PODOLSKY, HOLLIE (RBT)
Entity Type:Individual
Prefix:
First Name:HOLLIE
Middle Name:
Last Name:PODOLSKY
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4956 KEYSVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34608-3319
Mailing Address - Country:US
Mailing Address - Phone:352-942-0669
Mailing Address - Fax:
Practice Address - Street 1:4956 KEYSVILLE AVE
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34608-3319
Practice Address - Country:US
Practice Address - Phone:352-942-0669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-02
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-15-02137172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker