Provider Demographics
NPI:1528526050
Name:CORRENTE, HOLLY BETH (MT-BC)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:BETH
Last Name:CORRENTE
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:BETH
Other - Last Name:MAYKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MT-BC
Mailing Address - Street 1:21 INGRAHAM ST
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-5005
Mailing Address - Country:US
Mailing Address - Phone:401-595-2393
Mailing Address - Fax:
Practice Address - Street 1:21 INGRAHAM ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-5005
Practice Address - Country:US
Practice Address - Phone:401-595-2393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-04
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA07020225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist