Provider Demographics
NPI:1518246065
Name:STILWELL, HOLLY MARIE (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:MARIE
Last Name:STILWELL
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 1:109 CONSTITUTION DR.
Mailing Address - Street 2:ST. 300
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-7606
Mailing Address - Country:US
Mailing Address - Phone:478-718-3499
Mailing Address - Fax:
Practice Address - Street 1:109 CONSTITUTION DR STE 300
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-8932
Practice Address - Country:US
Practice Address - Phone:478-718-3499
Practice Address - Fax:478-718-3499
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-15
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist