Provider Demographics
NPI:1508190299
Name:HOLLNAGEL, CAROLINE RENEE (PHD)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:RENEE
Last Name:HOLLNAGEL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:
Other - Last Name:ODELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:43 WHITING HILL RD STE 300
Mailing Address - Street 2:
Mailing Address - City:BREWER
Mailing Address - State:ME
Mailing Address - Zip Code:04412-1006
Mailing Address - Country:US
Mailing Address - Phone:207-973-7000
Mailing Address - Fax:
Practice Address - Street 1:417 STATE ST STE 209
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401
Practice Address - Country:US
Practice Address - Phone:207-973-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-28
Last Update Date:2018-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23040103T00000X
MEPS1526103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist