Hollis, Mary Lou

Hollis, Mary Lou is an sole proprietor health care provider with primary practice located at 5464 Holiday Ter , Kalamazoo MI 49009-2147. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Hollis, Mary Lou can be contacted via phone (269) 372-1940.

Contact Information

Primary practice address
5464 Holiday Ter Kalamazoo MI 49009-2147
Fax: (269) 349-5105
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 6301002452 Michigan
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 4101005257 Michigan

Profile Details

NPI number 1013914274
LBN Legal business name Hollis, Mary Lou
Credentials ED.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 3rd, 2005
Last updated Jul 8th, 2007 - about 17 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 1013914274 NPPES
Michigan Other OC945940 BCBSM
Michigan Other 007039 BCBSM

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