Provider Demographics
NPI:1184892994
Name:BARRUSO, HOLLY B (MA)
Entity type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:B
Last Name:BARRUSO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3071 ROMAIN TRL
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174-6176
Mailing Address - Country:US
Mailing Address - Phone:615-618-2080
Mailing Address - Fax:
Practice Address - Street 1:3071 ROMAIN TRL
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174-6176
Practice Address - Country:US
Practice Address - Phone:615-618-2080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-14
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3376955OtherGROUP MEDICARE