Individual
MRS. HOLLY ELISE POMME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
613 N 1ST AVE, STAYTON, OR 97383-1704
(541) 704-7511
(503) 386-2677
Mailing address
613 N 1ST AVE, STAYTON, OR 97383-1704
(541) 704-7511
(503) 386-2677
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
L-6179
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497958078
—
OR
05
—
1669830865
—
OR
Enumeration date
06/08/2007
Last updated
08/23/2021
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