Provider Demographics
NPI:1437210598
Name:MASSIE, HOLLY DAWN
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:DAWN
Last Name:MASSIE
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:PO BOX 917
Mailing Address - Street 2:
Mailing Address - City:HAMILTON CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95951
Mailing Address - Country:US
Mailing Address - Phone:530-826-3931
Mailing Address - Fax:
Practice Address - Street 1:260 COHASSET ROAD
Practice Address - Street 2:SUITE E
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926
Practice Address - Country:US
Practice Address - Phone:530-895-6650
Practice Address - Fax:530-895-6597
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered171M00000XOther Service ProvidersCase Manager/Care Coordinator
Not Answered225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor