Individual
CHARLENE ANNE HOLLOWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
855 N CAPITAL AVE STE 1, IDAHO FALLS, ID 83402-3405
(208) 552-0855
(208) 523-1132
Mailing address
855 N CAPITAL AVE STE 1, IDAHO FALLS, ID 83402-3405
(208) 552-0855
(208) 523-1132
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LMSW44331
ID
Other
Enumeration date
01/10/2024
Last updated
01/10/2024
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