Most Relevant Information
Provider Data
| NPI Number: | 1003453440 |
| Provider Name: | HOLLY SLY MA |
| Entity Type: | Individual |
| Taxonomy Code: | 103T00000X |
| Specialty: | Psychologist |
| License Number: | 1239 |
Most Important Dates
| Enumeration Date: | 12/04/2019 |
| Last Updated: | 12/04/2019 |
Provider Practice Location
101 S EISENHOWER DR
BECKLEY
WV
258014929
Practice Location Phone/Fax
| Phone: | 3042567100 |
| Fax: |
Provider Mailing Location
101 S EISENHOWER DR
BECKLEY
WV
258014929
Provider Mailing Phone/Fax
| Phone: | 3042567100 |
| Fax: |