Provider Demographics
NPI:1841328291
Name:HOLLINGER, MARY R
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:R
Last Name:HOLLINGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:R
Other - Last Name:BECKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:13307 N BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-3317
Mailing Address - Country:US
Mailing Address - Phone:813-600-5092
Mailing Address - Fax:305-359-3855
Practice Address - Street 1:13307 N BOULEVARD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-3317
Practice Address - Country:US
Practice Address - Phone:813-600-5092
Practice Address - Fax:305-359-3855
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 5481101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health