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Individual

CAROLYN HOLLISTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LISW

Contact information

Practice address
1605 N ANKENY BLVD STE 110, ANKENY, IA 50023-4163
(515) 520-8164
(515) 209-7756
Mailing address
1605 N ANKENY BLVD STE 110, ANKENY, IA 50023-4163
(515) 402-1047

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
107365
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
107365
SOCIAL WORK LICENSE
IA
Enumeration date
06/17/2021
Last updated
08/16/2023
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