| Doctor Name: | KIMBERLY G HOLLISTER |
| NPI Number: | 1740512169 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A., LPC, LCMHC |
| License Number: | 60549 |
| Business Practice Address: | 20 W Canal St Ste C6 Winooski, VT - 054042131 |
| Business Phone Number: | 8028817396 |
| Business Fax Number: | |
| Mailing Address: | 20 W Canal St, Ste C6 WINOOSKI |
| State: | VT |
| Postal Code: | 054042131 |
| Phone Number: | 8028817396 |
| Fax Number: | |
| NPI Enumeration Date: | 02/10/2010 |
| NPI Last Update Date: | 03/24/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 60549 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |