Provider Demographics
NPI:1942021043
Name:HOLLIFIELD, MAKAYLA SHAKARA
Entity type:Individual
Prefix:
First Name:MAKAYLA
Middle Name:SHAKARA
Last Name:HOLLIFIELD
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 1:10746 WITCHER DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80925-9664
Mailing Address - Country:US
Mailing Address - Phone:615-779-4898
Mailing Address - Fax:
Practice Address - Street 1:157 FONTAINE BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80911-2110
Practice Address - Country:US
Practice Address - Phone:615-779-4898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor