Provider Demographics
NPI:1366788788
Name:DAVIES, HOLLY MARIE (MS)
Entity type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:MARIE
Last Name:DAVIES
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7200 MERIONTRACE
Mailing Address - Street 2:APT B204
Mailing Address - City:UPPER DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19082
Mailing Address - Country:US
Mailing Address - Phone:267-229-1342
Mailing Address - Fax:
Practice Address - Street 1:7200 MERIONTRACE
Practice Address - Street 2:APT B204
Practice Address - City:UPPER DARBY
Practice Address - State:PA
Practice Address - Zip Code:19082
Practice Address - Country:US
Practice Address - Phone:267-229-1342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-13
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst