Provider Demographics
NPI:1457985301
Name:HOLLOWAY, AMANDA (CSFA)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:HOLLOWAY
Suffix:
Gender:F
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:364 NEW BRAINTREE RD
Mailing Address - Street 2:
Mailing Address - City:OAKHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01068-9792
Mailing Address - Country:US
Mailing Address - Phone:561-254-8921
Mailing Address - Fax:
Practice Address - Street 1:364 NEW BRAINTREE RD
Practice Address - Street 2:
Practice Address - City:OAKHAM
Practice Address - State:MA
Practice Address - Zip Code:01068-9792
Practice Address - Country:US
Practice Address - Phone:561-254-8921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-01
Last Update Date:2020-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant