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Organization
HOLLY SKINNER LLC
Active
Organization
HOLLY SKINNER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOLLY SKINNER LPC (LICENSED PROFESSIONAL COUNSELOR)
(417) 894-9832
Entity
Organization
Contact information
Practice address
1 W SUNBRIDGE DR, FAYETTEVILLE, AR 72703-1825
(479) 443-5575
Mailing address
1 W SUNBRIDGE DR, FAYETTEVILLE, AR 72703-1825
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
P1801008
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1437589777
NPI
—
Enumeration date
03/09/2018
Last updated
03/09/2018
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