Provider Demographics
NPI:1114253762
Name:HOLLINGS, JANE
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:HOLLINGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5318 HIGHGATE DR
Mailing Address - Street 2:STE 131
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-6630
Mailing Address - Country:US
Mailing Address - Phone:919-419-0524
Mailing Address - Fax:919-419-9651
Practice Address - Street 1:5318 HIGHGATE DR
Practice Address - Street 2:STE 131
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-6630
Practice Address - Country:US
Practice Address - Phone:919-419-0524
Practice Address - Fax:919-419-9651
Is Sole Proprietor?:No
Enumeration Date:2009-11-02
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004656101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional