Individual
HOLLY MICHELLE GIFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-IT
Contact information
Practice address
W4051 COUNTY ROAD NN, ELKHORN, WI 53121-4338
(262) 741-3307
(262) 741-3315
Mailing address
1155 SAGE ST, LAKE GENEVA, WI 53147-1235
(262) 358-2411
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1416-226
WI
Other
Enumeration date
12/04/2012
Last updated
12/04/2012
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