Provider Demographics
NPI:1932679248
Name:MCCRAW, HOLLY FANN
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:FANN
Last Name:MCCRAW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:657 WOOD AVE
Mailing Address - Street 2:
Mailing Address - City:FROSTPROOF
Mailing Address - State:FL
Mailing Address - Zip Code:33843-2250
Mailing Address - Country:US
Mailing Address - Phone:863-206-4010
Mailing Address - Fax:
Practice Address - Street 1:657 WOOD AVE
Practice Address - Street 2:
Practice Address - City:FROSTPROOF
Practice Address - State:FL
Practice Address - Zip Code:33843-2250
Practice Address - Country:US
Practice Address - Phone:863-206-4010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-29
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health