Provider Demographics
NPI:1215988043
Name:HOLLOWAY, RICHARD L (PHD, LMFT)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:L
Last Name:HOLLOWAY
Suffix:
Gender:M
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 N 92ND ST
Mailing Address - Street 2:CLINICS AT CURATIVE
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3533
Mailing Address - Country:US
Mailing Address - Phone:414-456-8696
Mailing Address - Fax:414-456-6523
Practice Address - Street 1:1000 N 92ND ST
Practice Address - Street 2:CLINICS AT CURATIVE
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3533
Practice Address - Country:US
Practice Address - Phone:414-456-8696
Practice Address - Fax:414-456-6523
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI106106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
002000225DOtherHUMANA