Holladay, Kelly

Holladay, Kelly is an individual health care provider with primary practice located at 3236 Landmark Dr Suite 103, North Charleston SC 29418-8488. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as her primary health care specialty. Holladay, Kelly can be contacted via phone (336) 416-6364.

Contact Information

Primary practice address
3236 Landmark Dr Suite 103 North Charleston SC 29418-8488
Phone: (336) 416-6364
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X

Profile Details

NPI number 1568703510
LBN Legal business name Holladay, Kelly
Credentials BCBA
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2013
Last updated Aug 5th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568703510 NPPES
South Carolina MEDICAID BB1001

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