Provider Demographics
NPI:1295125524
Name:HOLLINGSWORTH, MERISSA ANN (DC)
Entity type:Individual
Prefix:DR
First Name:MERISSA
Middle Name:ANN
Last Name:HOLLINGSWORTH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15118 AQUARIUS ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78418-6903
Mailing Address - Country:US
Mailing Address - Phone:254-592-4298
Mailing Address - Fax:
Practice Address - Street 1:6200 SARATOGA BLVD UNIT 2
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-3478
Practice Address - Country:US
Practice Address - Phone:361-717-1608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-26
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11967111N00000X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No111N00000XChiropractic ProvidersChiropractor