Individual
JASON EDWIN HOLLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMHC
Contact information
Practice address
917 PLACITA CHACO, SANTA FE, NM 87505-6253
(505) 603-0705
Mailing address
917 PLACITA CHACO, SANTA FE, NM 87505-6253
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0112621
NM
Other
Enumeration date
01/31/2011
Last updated
01/31/2011
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