Provider Demographics
NPI:1467694240
Name:STONER, HOLLY (LMFT)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:STONER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 W SILVER SPRING DR
Mailing Address - Street 2:SUITE K270
Mailing Address - City:GLENDALE
Mailing Address - State:WI
Mailing Address - Zip Code:53217-5051
Mailing Address - Country:US
Mailing Address - Phone:414-964-4357
Mailing Address - Fax:414-964-4327
Practice Address - Street 1:500 W SILVER SPRING DR
Practice Address - Street 2:SUITE K270
Practice Address - City:GLENDALE
Practice Address - State:WI
Practice Address - Zip Code:53217-5051
Practice Address - Country:US
Practice Address - Phone:414-964-4357
Practice Address - Fax:414-964-4327
Is Sole Proprietor?:No
Enumeration Date:2009-03-25
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI807-124106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist