Individual
TONYA HOLLIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1223 S RAILROAD AVE, SUGAR CITY, ID 83448-5072
(208) 359-0519
(208) 233-2178
Mailing address
1223 S RAILROAD AVE, SUGAR CITY, ID 83448-5072
(208) 359-0519
(208) 233-2178
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
LMSW35094
ID
1041C0700X
Clinical Social Worker
Primary
LCSW-38181
ID
Other
Enumeration date
10/31/2018
Last updated
01/04/2021
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