Provider Demographics
NPI:1023634052
Name:TERRY-HOLLOWAY, TWYLLA R
Entity type:Individual
Prefix:MRS
First Name:TWYLLA
Middle Name:R
Last Name:TERRY-HOLLOWAY
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 1:24085 AMADOR ST FL 4
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94544-1226
Mailing Address - Country:US
Mailing Address - Phone:510-670-5692
Mailing Address - Fax:510-670-6123
Practice Address - Street 1:24085 AMADOR ST FL 4
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94544-1226
Practice Address - Country:US
Practice Address - Phone:510-670-5692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-25
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator