Provider Demographics
NPI:1770627101
Name:HOLLOWAY, DEBORAH MAE
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:MAE
Last Name: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 1:3088 W 15TH AVE
Mailing Address - Street 2:#10
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-3171
Mailing Address - Country:US
Mailing Address - Phone:541-461-2845
Mailing Address - Fax:
Practice Address - Street 1:1790 W 11TH AVE
Practice Address - Street 2:SUITE 290
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-3758
Practice Address - Country:US
Practice Address - Phone:541-626-1262
Practice Address - Fax:541-626-0359
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health