Individual
JILL MARIE HOLLENBECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSWAIC
Contact information
Practice address
32637 ASH AVE SE, BLACK DIAMOND, WA 98010-5080
(206) 501-1253
Mailing address
PO BOX 1118, MAPLE VALLEY, WA 98010-1118
(206) 501-1253
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SC60289635
WA
Other
Enumeration date
07/18/2023
Last updated
07/18/2023
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