| Doctor Name: | HOLLY ANNE MATTINGLY |
| NPI Number: | 1053631663 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCPC |
| License Number: | 180.009307 |
| Business Practice Address: | 125 Windsor Dr Suite 113 Oak Brook, IL - 605231536 |
| Business Phone Number: | 6307071799 |
| Business Fax Number: | |
| Mailing Address: | 4225 Saratoga Ave, Unit 415b DOWNERS GROVE |
| State: | IL |
| Postal Code: | 605151972 |
| Phone Number: | 6307071799 |
| Fax Number: | |
| NPI Enumeration Date: | 06/04/2010 |
| NPI Last Update Date: | 02/03/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 180.009307 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |