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Individual

MARY LOUISE HOLLENBAUGH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
533 TRENTON DR, FORT LEE, VA 23801-1494
(435) 830-3953
Mailing address
533 TRENTON DR, FORT LEE, VA 23801-1494
(435) 830-3953

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701005168
VA
101YP2500X
Professional Counselor
5570271-6004
UT

Other

Enumeration date
01/23/2012
Last updated
01/23/2012
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