Individual ProviderHolly InmanCounselorBehavioral Health & Social Service ProvidersPractice Address10621 N 37th Pl, Phoenix, AZ 85028-3410(602) 469-7302PECOS EnrollmentBased on the most recent information from CMS, provider Holly Inman is legally eligible to order and refer claims for Part B and DME services only.Part BMedicare Part BEnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1841755188Provider TypeIndividualFull NameInman, HollyGenderFemaleSole ProprietorYesEnumeration Date1/31/2019Last Updated1/31/2019Contact InformationPractice LocationPractice Address10621 N 37th Pl, Phoenix, AZ 85028-3410Phone(602) 469-7302FaxUnlisted FaxMailing LocationMailing Address10621 N 37th Pl, Phoenix, AZ 85028-3410Phone(602) 469-7302FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseLPC-17284Arizona