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1790547685
RUSSELL HOLLOWAY
DAYTONA BEACH, FL
NPI
1790547685
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: FL MH10816)
Enumeration Date
2024-01-25
Last Update Date
2024-01-25
Business Address
RUSSELL HOLLOWAY
215 S PALMETTO AVE
DAYTONA BEACH, FL 32114-4308
Phone number: 386-212-3634
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Mailing Address
RUSSELL HOLLOWAY
215 S PALMETTO AVE
DAYTONA BEACH, FL 32114-4308
Phone number: 386-212-3634
Copy
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