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Individual

MS. HOLLY R WADE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCPC, LPC

Contact information

Practice address
15394 REVERE DR, NEW FREEDOM, PA 17349-9085
(443) 904-2715
Mailing address
15394 REVERE DR, NEW FREEDOM, PA 17349-9085
(443) 904-2715

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
LC3484
MD
101YP2500X
Professional Counselor
Primary
PC010486
PA

Other

Enumeration date
05/10/2010
Last updated
05/07/2021
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