Provider Demographics
NPI:1144013707
Name:HOLLOWAY, KIMBERLY DAWN (BSW)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:DAWN
Last Name:HOLLOWAY
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 W MOCKINGBIRD LN STE 480
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247-5062
Mailing Address - Country:US
Mailing Address - Phone:870-219-9455
Mailing Address - Fax:870-219-9455
Practice Address - Street 1:1111 W MOCKINGBIRD LN STE 480
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75247-5062
Practice Address - Country:US
Practice Address - Phone:870-219-9455
Practice Address - Fax:870-219-9455
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-27
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No171M00000XOther Service ProvidersCase Manager/Care Coordinator