Provider Demographics
NPI:1467118984
Name:WILLIAMS, HOLLY CLARE (PHD)
Entity Type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:CLARE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 VEREO ST
Mailing Address - Street 2:
Mailing Address - City:CEDAR CREEK
Mailing Address - State:TX
Mailing Address - Zip Code:78612-4297
Mailing Address - Country:US
Mailing Address - Phone:512-773-4133
Mailing Address - Fax:
Practice Address - Street 1:112 VEREO ST
Practice Address - Street 2:
Practice Address - City:CEDAR CREEK
Practice Address - State:TX
Practice Address - Zip Code:78612-4297
Practice Address - Country:US
Practice Address - Phone:512-773-4133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-09
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25164103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX25164OtherTEXAS STATE BOARD OF EXAMINERS OF PSYCHOLOGISTS