Individual
HOLLY GODFREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPC INTERN
Contact information
Practice address
3606 N RANCHO DR STE 142, LAS VEGAS, NV 89130-3130
(702) 449-5225
(702) 778-5301
Mailing address
3606 N RANCHO DR STE 142, LAS VEGAS, NV 89130-3130
(702) 449-5225
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10052163
—
NV
Enumeration date
09/16/2020
Last updated
09/16/2020
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