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Individual

MRS. JAN K HOLLINGSWORTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPCC

Contact information

Practice address
9631 MORROW AVE NE, ALBUQUERQUE, NM 87112-2951
(505) 275-2584
Mailing address
9631 MORROW AVE NE, ALBUQUERQUE, NM 87112-2951
(505) 275-2584

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0803
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100626
NM
01
118824
VALUE OPTIONS COMMERCIAL
NM
01
2202654
CIGNA LPCC PROVIDER
NM
01
NM LICENSE # 0803
CLINICAL MH COUNSELOR
NM
Enumeration date
08/01/2006
Last updated
07/09/2007
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