Individual ProviderShelley L HollowayCounselorBehavioral Health & Social Service ProvidersPractice Address151 Mystic St, Medford, MA 02155(914) 346-2692PECOS EnrollmentBased on the most recent information from CMS, provider Shelley L Holloway does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 10:04 AM.Profile DetailsProvider ID1467756346Provider TypeIndividualFull NameHolloway, Shelley LCredentialM.EDGenderFemaleSole ProprietorNoEnumeration Date1/6/2011Last Updated8/16/2018Contact InformationPractice LocationPractice Address151 Mystic St, Medford, MA 02155Phone(914) 346-2692FaxUnlisted FaxMailing LocationMailing Address151 Mystic St, Medford, MA 02155-3441Phone(914) 346-2692FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerMassachusetts