Provider Demographics
NPI:1457982795
Name:HOLLINGSWORTH, ELIZABETH MARINE (BS, BHWC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MARINE
Last Name:HOLLINGSWORTH
Suffix:
Gender:F
Credentials:BS, BHWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1359 E 45TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-4105
Mailing Address - Country:US
Mailing Address - Phone:918-409-7481
Mailing Address - Fax:
Practice Address - Street 1:7010 S YALE AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-5713
Practice Address - Country:US
Practice Address - Phone:918-236-8598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-27
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator