Provider Demographics
NPI:1922800507
Name:WOOD, HOLLEY MARIE
Entity type:Individual
Prefix:
First Name:HOLLEY
Middle Name:MARIE
Last Name:WOOD
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 1:70 W MAIN ST STE 301
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06051-4224
Mailing Address - Country:US
Mailing Address - Phone:860-960-3530
Mailing Address - Fax:
Practice Address - Street 1:70 W MAIN ST STE 301
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06051-4224
Practice Address - Country:US
Practice Address - Phone:860-960-3530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach