| Doctor Name: | MRS. TAMMIE MERANDA HOLLOWAY-RAINES |
| NPI Number: | 1609006923 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MASTERS MENTAL DISAB |
| License Number: | |
| Business Practice Address: | 508 Jones St Roxboro, NC - 275735018 |
| Business Phone Number: | 3365994867 |
| Business Fax Number: | |
| Mailing Address: | 1130 Allensville Rd, ROXBORO |
| State: | NC |
| Postal Code: | 275747057 |
| Phone Number: | 9193582773 |
| Fax Number: | |
| NPI Enumeration Date: | 07/21/2009 |
| NPI Last Update Date: | 07/21/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 320600000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Residential Treatment Facilities |
| Taxonomy Classification: | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |