Individual
HOLLY LYNN WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1707 MAIN ST, LA CROSSE, WI 54601-4200
(608) 785-0001
(608) 785-0002
Mailing address
66 E 3RD ST, 201, WINONA, MN 55987-3478
(507) 452-7292
(507) 457-9887
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
00271
MN
101YP2500X
Professional Counselor
Primary
3719-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
401K8WA
BCBS-MN
MN
05
—
40999200
—
WI
01
—
HP66806
HEALTHPARTNERS
MN
Enumeration date
01/22/2007
Last updated
07/09/2007
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