Provider Demographics
NPI:1891514691
Name:LOSS, HOLLY M (DPP COACH)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:M
Last Name:LOSS
Suffix:
Gender:F
Credentials:DPP COACH
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:M
Other - Last Name:SHEPPARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:401 BOW ST
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921-5515
Mailing Address - Country:US
Mailing Address - Phone:443-245-3744
Mailing Address - Fax:
Practice Address - Street 1:401 BOW ST
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-5515
Practice Address - Country:US
Practice Address - Phone:443-245-3744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-08
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach