Provider Demographics
NPI:1861532384
Name:HOLLIDAY, PATRICIA JO (MSW)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:JO
Last Name:HOLLIDAY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6220 ALDINE
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116
Mailing Address - Country:US
Mailing Address - Phone:810-227-2902
Mailing Address - Fax:
Practice Address - Street 1:2020 E GRAND RIVER
Practice Address - Street 2:LIVINGSTON COUNTY CATHOLIC SOCIAL SERVICES
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843
Practice Address - Country:US
Practice Address - Phone:517-545-5944
Practice Address - Fax:517-545-7390
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6802076280104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker