Provider Demographics
NPI:1568844793
Name:SCHILLING, HOLLY (PHD)
Entity Type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:
Last Name:SCHILLING
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:HOLLY
Other - Middle Name:M
Other - Last Name:RUSINKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2989 MAHAN DRIVE
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308
Mailing Address - Country:US
Mailing Address - Phone:701-330-2856
Mailing Address - Fax:
Practice Address - Street 1:2989 MAHAN DRIVE
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308
Practice Address - Country:US
Practice Address - Phone:850-552-0691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY003586103T00000X
FLPY9053103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist