| Doctor Name: | DR. MARY LOU HOLLIS |
| NPI Number: | 1013914274 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ED.D. |
| License Number: | 6301002452 |
| Business Practice Address: | 5464 Holiday Ter Kalamazoo, MI - 490092147 |
| Business Phone Number: | 2693721940 |
| Business Fax Number: | 2693495105 |
| Mailing Address: | 5464 Holiday Ter, KALAMAZOO |
| State: | MI |
| Postal Code: | 490092147 |
| Phone Number: | 2693721940 |
| Fax Number: | 2693495105 |
| NPI Enumeration Date: | 07/03/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 6301002452 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |