Doctor Name: | HOLLY WALTON |
NPI Number: | 1710363056 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | PC008334 |
Business Practice Address: | 1018 Sugar Run Rd Eighty Four, PA - 153302450 |
Business Phone Number: | 7244706133 |
Business Fax Number: | |
Mailing Address: | 1018 Sugar Run Rd, EIGHTY FOUR |
State: | PA |
Postal Code: | 153302450 |
Phone Number: | 7244706133 |
Fax Number: | |
NPI Enumeration Date: | 08/10/2015 |
NPI Last Update Date: | 08/10/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | PC008334 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |