Provider Demographics
NPI:1770670747
Name:HOLLIS, WINDSONG (MD)
Entity type:Individual
Prefix:
First Name:WINDSONG
Middle Name:
Last Name:HOLLIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:WINDSONG
Other - Middle Name:
Other - Last Name:LANFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:327 A ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-5910
Mailing Address - Country:US
Mailing Address - Phone:303-808-2132
Mailing Address - Fax:
Practice Address - Street 1:3302 GALLOWS RD
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-3353
Practice Address - Country:US
Practice Address - Phone:703-207-7168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-09
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC243482084N0400X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology