Provider Demographics
NPI:1952464489
Name:HOLLOWAY, MARJAN G (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARJAN
Middle Name:G
Last Name:HOLLOWAY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:MARJAN
Other - Middle Name:GHAHRAMANLOU
Other - Last Name:HOLLOWAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4301 JONES BRIDGE RD RM B3050
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-4712
Mailing Address - Country:US
Mailing Address - Phone:301-295-3271
Mailing Address - Fax:301-295-3034
Practice Address - Street 1:4301 JONES BRIDGE RD RM B3050
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-4712
Practice Address - Country:US
Practice Address - Phone:301-295-3271
Practice Address - Fax:301-295-3034
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2015-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04126103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical