Provider Demographics
NPI:1386216695
Name:GUDINO, HOLLY (MSW LCSWA)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:GUDINO
Suffix:
Gender:F
Credentials:MSW LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 DUBLIN SQUARE RD STE A
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27203-8601
Mailing Address - Country:US
Mailing Address - Phone:336-860-3262
Mailing Address - Fax:336-521-7550
Practice Address - Street 1:138 DUBLIN SQUARE RD STE A
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-8601
Practice Address - Country:US
Practice Address - Phone:336-860-3262
Practice Address - Fax:336-521-7550
Is Sole Proprietor?:No
Enumeration Date:2021-07-15
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0165421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical